Has NICE been nice to cancer?

Summerhayes, M.; Catchpole, Paul

doi:10.1016/j.ejca.2006.08.013

Cited by 10 publications

(5 citation statements)

References 1 publication

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“…In contrast, use of individual AIs increased earlier and more gradually in England than in Australia. This could be explained by the ‘negative list’ system for prescription drugs under the UK's National Health Service, where drugs will be subsidized (depending on the resources of local healthcare regions) as soon as they are marketed unless specified otherwise . In 2011, the Danish Council for the use of expensive hospital medicines issued a guidance that recommended letrozole to be the drug of first choice as the end of patent for letrozole led to cheaper prizes in tenders .…”

Section: Discussionmentioning

confidence: 99%

Longitudinal trends in utilization of endocrine therapies for breast cancer: an international comparison

Kelly

Albertini

et al. 2014

J Clin Pharm Ther

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Our analysis found a shift in use of endocrine therapy from tamoxifen to aromatase inhibitors. This trend is consistent with major clinical guidelines endorsing preferential use of aromatase inhibitors in post-menopausal women. Stabilization or small increase in tamoxifen use in the recent years may reflect the recognition of tamoxifen as still an appropriate first-line treatment. The similarity in utilization patterns may be due to the relatively comparable healthcare systems in the countries, namely universal health insurance and pharmaceutical coverage. Differences in utilization observed could be due to differences in breast cancer incidence, prescribing behaviours, interpretation of new trial evidence, and timing of drug marketing approval and reimbursement between countries.

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Section: Discussionmentioning

confidence: 99%

Longitudinal trends in utilization of endocrine therapies for breast cancer: an international comparison

Kelly

Albertini

et al. 2014

J Clin Pharm Ther

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“…There are four types of guidance that NICE provides including: clinical guidelines, public health guidelines, guidelines on safety and efficacy of interventional procedures and recommendations on 'health technologies' (such as surgical interventions and pharmaceuticals; NICE, 2008b). One of the key rationales for setting up NICE was to help tackle the geographic inequality in access to technology or the phenomenon more frequently referred to as 'postcode prescribing' (Summerhayes and Catchpole, 2006). Since 2002, NICE's recommendations have been mandatory and NHS organisations have had to comply, usually within three months.…”

Section: Introductionmentioning

confidence: 99%

Decision making by NICE: examining the influences of evidence, process and context

Cerri

Knapp

Fernández

2013

HEPL

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:The National Institute for Health and Clinical Excellence (NICE) provides guidance to the National Health Service (NHS) in England and Wales on funding and use of new technologies. This study examined the impact of evidence, process and context factors on NICE decisions in [2004][2005][2006][2007][2008][2009]. A data set of NICE decisions pertaining to pharmaceutical technologies was created, including 32 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. With multinomial logistic regression, the relative contribution of explanatory variables on NICE decisions was assessed. A total of 65 technology appraisals (118 technologies) were analysed. Of the technologies, 27% were recommended, 58% were restricted and 14% were not recommended by NICE for NHS funding. The multinomial model showed significant associations (p < 0.10) between NICE outcome and four variables: (i) demonstration of statistical superiority of the primary endpoint in clinical trials by the appraised technology; (ii) the incremental cost-effectiveness ratio (ICER); (iii) the number of pharmaceuticals appraised within the same appraisal; and (iv) the appraisal year. Results confirm the value of a comprehensive and multivariate approach to understanding NICE decision making. New factors affecting NICE decision making were identified, including the effect of clinical superiority, and the effect of process and socio-economic factors.

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“…In England and Wales, HTA was introduced with the creation of NICE in 1999, which considers comparative effectiveness and cost-effectiveness data when evaluating new drugs. Unfortunately, no research has been undertaken on the impact of HTAs conducted by NICE on launch delay so far, but there are studies showing that positive guidance issued by NICE does not necessarily eradicate inequalities in access [ 35 ]. In research on drugs to treat orphan diseases, it has been found that while more than a half of the centrally approved pharmaceuticals were on the market in the investigated countries, patients’ access to orphan medical products was restricted by different national reimbursement policies, especially in the UK, Italy and Spain [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Does health technology assessment compromise access to pharmaceuticals?

Büssgen¹,

Stargardt²

2022

Eur J Health Econ

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In response to rapidly rising pharmaceutical costs, many countries have introduced health technology assessment (HTA) as a ‘fourth hurdle’. We evaluated the causal effect of HTA based regulation on access to pharmaceuticals by using the introduction of Germany’s HTA system (AMNOG) in 2011. We obtained launch data on pharmaceuticals for 30 European countries from the IQVIA (formerly IMS) database. Using difference-in-difference models, we estimated the effect of AMNOG on launch delay, the ranking order of launch delays, and the availability of pharmaceuticals. We then compared the results for Germany to Austria, Czechia, Italy, Portugal, and the UK. Across all six countries, launch delays decreased from the pre-AMNOG period (25.01 months) to the post-AMNOG period (14.34 months). However, the introduction of AMNOG consistently reduced the magnitude of the decrease in launch delay in Germany compared to the comparator countries (staggered DiD: + 4.31 months, p = 0.05). Our logit results indicate that the availability of pharmaceuticals in Germany increased as a result of AMNOG (staggered logit: + 5.78%, p = 0.009). We provide evidence on the trade-off between regulation and access. This can help policymakers make better-informed decisions to strike the right balance between cost savings achieved through HTA based regulation and access to pharmaceuticals.

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Has NICE been nice to cancer?

Cited by 10 publications

References 1 publication

Longitudinal trends in utilization of endocrine therapies for breast cancer: an international comparison

Longitudinal trends in utilization of endocrine therapies for breast cancer: an international comparison

Decision making by NICE: examining the influences of evidence, process and context

Does health technology assessment compromise access to pharmaceuticals?

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