The UK’s healthcare system is primarily public, but rising healthcare expenditure coupled with increasing demand is placing a strain on the system. For example, according to the Office for National Statistics, expenditure on healthcare in the UK rose from £54.8 billion in 1997 to £142.8 billion in 2011. These trends, which are not unique to the UK, have led to the use of Health Technology Assessment (HTA) to determine what represents value for money at the national level for healthcare services.
Since its establishment
as a Special Health Authority in 1999, the National Institute for Health and
Care Excellence (NICE) has become one of the leading organisations involved in
HTA. Its stated role is
to provide evidence-based guidance and advice for health, public health and
social care practitioners. In effect, NICE aims to give independent advice about which treatments should be available on the NHS in England and
Wales. The organisation often receives criticism
in the media regarding its decisions and pharmaceutical industry representatives have been wary of NICE and believe that reforms of
the UK’s approach to HTA are needed. However, NICE has also received several favourable reviews from
independent agencies including the House of Commons Health Committee, the World
Health Organization and independent academics.
In recent times, controversial NICE decisions regarding
Alzheimers and cancer drugs have led to considerable negative media coverage and complaints from patients, but despite this, its role within healthcare is expanding.
Reforms have seen the organisation expand its work into areas such as social care and it will be central to the introduction of value-based pricing (VBP), where the value of a drug will be based on an assessment of the
evidence available and will directly influence how the manufacturer is
In order to respond to its critics, NICE has highlighted its
commitment to transparency. On its website it features a number of opportunities for stakeholders
to contribute to the development of its recommendations. In addition, it runs
scientific advice seminars, where manufacturers of drugs, medical devices and other technologies and other interested parties can learn more
about NICE’s processes and what its assessors expect from submissions. The
success of these seminars has led to requests from other organisations for partnerships with NICE in order to reach a wider audience of developers, particularly at
international events. Companies can also book a site visit where the NICE team can explain in greater detail the organisation’s scientific
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