SLIDE 1
An introduction to NICE Navigating the Highly Specialised - - PowerPoint PPT Presentation
An introduction to NICE Navigating the Highly Specialised - - PowerPoint PPT Presentation
An introduction to NICE Navigating the Highly Specialised Technologies Programme Eli Gajraj, Senior Technical Adviser NICE Scientific Advice Why NICE? "If there was a company that was selling an Aston Martin at the price of a bicycle,
SLIDE 2
SLIDE 3
Pre-1999: Before NICE
- No quality standards
- Evidence overload - no
guidance for professionals
- Post code lottery - unexplained
and unpopular variation
- Efficiency - new expensive
technologies introduced
- Innovative treatments
underused
SLIDE 4
NICE was set up to….
- Reduce unwarranted
variation
- Set quality standards
- Accelerate uptake of good
value innovation
- Ensure additional resources
are spent efficiently
SLIDE 5
What does NICE do?
National Institute for Health and Care Excellence (NICE) provides independent, authoritative and evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health, reducing inequalities and variation to ensure quality and value for money for the NHS
SLIDE 6
If the NHS were an automobile……
HEALTH
£ 110 bn
SLIDE 7
Opportunity cost
SLIDE 8
How does NICE measure health?
Years of life Quality of life (QoL)
100% 0% (dead) 1 year 1 year at 100% QoL= 1 QALY 1 year 1 year at 50% QoL= 0.5 QALY
Quality Adjusted Life Year (QALY)
SLIDE 9
What is cost effectiveness?
Differences in cost Differences in health benefits Incremental Cost Effectiveness Ratio (ICER) NICE accepts £20,000 - £30,000 per QALY Threshold
SLIDE 10
Cost
+
Health benefit
_ + _
Yes, please! Are the additional benefits worth the extra cost?
Assessing costs and benefits
No thanks!
SLIDE 11
2 6 10 Incremental Cost £60k
+ _ Are additional benefits worth the extra cost?
£140k £220k Drug 1 Drug 4 Drug 2 Drug 3 NICE QALYs gained (Effect)
SLIDE 12
What else does NICE value?
- Innovation
– is new – constitutes an improvement on existing products – offers something more: a step-change in terms of outcomes for patients
- Reducing health inequalities
- Non-health objectives of the NHS
– Broader social considerations
SLIDE 13
What else does NICE do?
- Evidence-based guidance - best practice
recommendations based on a review of the evidence – Clinical guidelines - Specific conditions – Public health - prevent disease or improve health – Social care - Improve outcomes in social care
- Quality standard and performance metrics
– Quality Standards
- Concise statement and accompanying metrics
- Drive and measure quality improvement
– Quality Outcomes Framework
- Clinical component of quality element of contract
between NHS and GPs
SLIDE 14
How are patients involved?
- Are members of committees
- Give expert evidence to committees
- Citizens council
– public perspective on overarching moral and ethical issues
- Participate in development of method guides
- Observe committee meetings
- Give Scientific Advice to developers
- Patient Involvement Programme