Intended for healthcare professionals

News Roundup [abridged Versions Appear In The Paper Journal]

NICE plans faster guidance on drugs for the NHS

BMJ 2005; 331 doi: (Published 29 September 2005) Cite this as: BMJ 2005;331:716
  1. Susan Mayor
  1. London

    The National Institute for Health and Clinical Excellence (NICE), the body that develops guidance on the use of treatments for the NHS in England and Wales, said last week that it is discussing proposals with the Department of Health to appraise new drugs and health technologies more rapidly.

    The process that NICE currently uses for technology appraisals of new or existing drugs has been criticised by patients' organisations as being too slow, typically taking 14-16 months (BMJ 2005;331:652, 24 Sep).

    The process starts with commissioning an independent academic centre to review published evidence on the technology and to prepare an assessment report. Groups representing patients, carers, healthcare professionals, and companies producing the drugs or devices being assessed are then invited to comment on the report.

    The assessment report and the comments are combined in an evaluation report, which is used by an independent appraisal committee to develop a consultation document that is circulated widely for comments that are used to inform the final appraisal.

    At a meeting last week NICE's board considered proposals on how to develop more rapid advice on what it termed “important” new drugs and health technologies. These proposals were submitted to the health department for “urgent discussion prior to a final decision on their adoption.”

    A spokeswoman for NICE said the aim would be to complete the appraisal process in around six months. She added that the institute would prioritise drugs with the potential to extend life expectancy. In many cases NICE may be ready to produce its guidance very shortly after a new drug is licensed, she said.

    Andrew Dillon, chief executive of NICE, said: “We have listened to what patients and healthcare professionals have told us about the need for timely advice on the use of new medicines, particularly for life threatening conditions such as cancer. We have responded by proposing a new, streamlined process for single drugs, and we think these proposals can make a real difference.”

    A spokesperson for the health department said that it would consider the proposals quickly: “The Department of Health will be discussing NICE's proposals with the institute over the coming days. We fully appreciate the importance of this issue, and ministers have asked that discussions be completed within weeks.”

    The cancer support organisation CancerBACUP recently warned that approval for 23 cancer treatments was being held up because of delays in the system. For example, rituximab, which is used to treat non-Hodgkin's lymphoma, was delayed for three years, and cetuximab, used to treat colorectal cancer, took two and a half years to be appraised by NICE.

    Joanne Rule, chief executive of CancerBACUP, said: “Fast tracking is part of the answer, but the Department of Health has to look at the whole process from licence to guidance. We want an expert group to look at every cancer drug within three months of its licence.”

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