An introduction to NICE Navigating the Highly Specialised - - PowerPoint PPT Presentation

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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,


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An introduction to NICE

Navigating the Highly Specialised Technologies Programme Eli Gajraj, Senior Technical Adviser NICE Scientific Advice

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Why NICE?

"If there was a company that was selling an Aston Martin at the price of a bicycle, and we buy that company and we ask to charge Toyota prices, I don't think that that should be a crime."

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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

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NICE was set up to….

  • Reduce unwarranted

variation

  • Set quality standards
  • Accelerate uptake of good

value innovation

  • Ensure additional resources

are spent efficiently

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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

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If the NHS were an automobile……

HEALTH

£ 110 bn

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Opportunity cost

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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)

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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

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Cost

+

Health benefit

_ + _

Yes, please! Are the additional benefits worth the extra cost?

Assessing costs and benefits

No thanks!

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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)

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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

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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

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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