National Institute for Health and Care Excellence

National Institute for Health and Clinical ExcellenceNICENational Institute for Clinical ExcellenceNational Institute for Health and Care Excellence (NICE)National Institute of Clinical ExcellenceNICE guidelinesNational Institute of Health and Care ExcellenceHealth Development Agency National Institute of Clinical Excellence (NICE)National Institute for Health & Clinical Excellence
The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health in the United Kingdom, which publishes guidelines in four areas: * the use of health technologies within the National Health Service (NHS) (such as the use of new and existing medicines, treatments and procedures) * clinical practice (guidance on the appropriate treatment and care of people with specific diseases and conditions) * guidance for public sector workers on health promotion and ill-health avoidance * guidance for social care services and users.wikipedia
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Evidence-based medicine

evidence-basedmedical evidenceevidence
These appraisals are based primarily on evidence-based evaluations of efficacy, safety and cost-effectiveness in various circumstances.
In 1999, the National Institute for Clinical Excellence (NICE) was created in the UK.

Andrew Dillon

Andrew Patrick Dillon, CBE
Later, this policy development whereby the criteria for decision making, the role of costs, and the degree to which decisions of NICE and the secretary of state would be binding on clinicians was analysed by Andrew Dillon, Trevor Gibbs, Tim Riley, and Trevor A. Sheldon.
Sir Andrew Dillon, (born 9 May 1954) is a British executive, who has been chief executive of the National Institute for Health and Care Excellence (NICE) since 1999.

Michael Rawlins

Sir Michael RawlinsMichael David RawlinsProfessor Sir Michael Rawlins
Riley joined Sir Michael Rawlins (the then recently appointed Chair of NICE) at the Health Select Committee in February 1999 where questions were raised as to whether NICE was just a means to "ration" healthcare.
He was Chair of the National Institute for Health and Care Excellence (NICE) from 1999 to 2013.

National Health Service (England)

National Health ServiceNHSNHS England
It serves both the English NHS and the Welsh NHS.
The numbers of smokers getting help to quit has fallen due to cuts in funding for smoking cessation care though the National Institute for Health and Care Excellence recommends such help.

NHS special health authority

special health authorityNHS special health authoritiesspecial health authorities
Following the Health and Social Care Act 2012, NICE was renamed the National Institute for Health and Care Excellence on 1 April 2013 reflecting its new responsibilities for social care, and changed from a special health authority to an Executive Non-Departmental Public Body (NDPB).

Health and Social Care Act 2012

Health and Social Care BillNHS reformsHealth and Social Care Act
Following the Health and Social Care Act 2012, NICE was renamed the National Institute for Health and Care Excellence on 1 April 2013 reflecting its new responsibilities for social care, and changed from a special health authority to an Executive Non-Departmental Public Body (NDPB).
Kieran Walshe, professor of health policy and management and Chris Ham, chief executive of the King's Fund, have argued that "At a national level, it is difficult to see who, if anyone, will be in charge of the NHS. There will be five key national bodies: the Department of Health, the National Institute for Health and Clinical Excellence, the Care Quality Commission, the NHS Commissioning Board, and the economic regulator Monitor. Although the remit of each is set out in legislation, it is not clear how these national bodies will interact or how they will provide coordinated and consistent governance of the NHS."

National Collaborating Centre for Mental Health

The centres are the National Collaborating Centre for Cancer, the National Clinical Guideline Centre, the National Collaborating Centre for Women and Children´s Health, and the National Collaborating Centre for Mental Health.
The NCCMH began producing clinical guidelines for the National Institute for Health and Care Excellence (NICE).

Muir Gray

JA Muir GrayJohn Armstrong Muir Gray
In 1996, the UK National Screening Committee (NSC) had been established by Sir Kenneth Calman and Muir Gray (now Sir Muir Gray) by the Policy Team led by Dr Tim Riley and latterly Sir Charles Nightingale for the Department of Health.
He held the positions of director at the UK National Screening Committee, during which he helped pioneer Britain's breast and cervical cancer screening programmes, and National Library for Health, and director of Clinical Knowledge Process and Safety for the NHS National Programme for IT.

National Health Service

NHSNational Health Service (NHS)National Health Services
(in the US drugs cost more than twice what they cost in the UK.) They want, “full market access” for US drugs, which would greatly reduce the capability of the National Institute for Clinical Excellence (NICE) to decide which drugs provide value for money.

Cancer Drugs Fund

In the case of cancer the Cancer Drugs Fund was set up in 2011 after complaints about NICE decisions on new and expensive cancer drugs with limited benefits.
It was established in order to provide a means by which National Health Service (NHS) patients in England could get cancer drugs rejected by National Institute for Health and Care Excellence because they were not cost effective.

Lenalidomide

RevlimidCC-5013lenaldomide
The first drug to go through the new process was Lenalidomide, whose ICER was £43,800.
In 2009, The National Institute for Health and Clinical Excellence (NICE) issued a Final Appraisal Determination (FAD) approving lenalidomide, in combination with dexamethasone, as an option to treat people with multiple myeloma who have received two or more prior therapies in England and Wales.

Economic evaluation

Economic evaluations are carried out within a health technology assessment framework to compare the cost-effectiveness of alternative activities and to consider the opportunity cost associated with their decisions.
It is most commonly employed in the context of health economics and health technology assessment; in the UK, the National Institute for Health and Care Excellence publishes guidelines for the conduct of economic evaluations.

Donepezil

Aricept
Some of the more controversial NICE decisions have concerned donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and bevacizumab, sorafenib, sunitinib and temsirolimus for renal cell carcinoma.
The UK National Institute for Clinical Excellence (NICE) recommends donepezil as an option in the management of mild to moderate Alzheimer's disease.

Quality-adjusted life year

QALYquality-adjusted life years(QALY),
NICE guidance supports the use of quality-adjusted life years (QALY) as the primary outcome for quantifying the expected health benefits associated with a given treatment regime.
In the United Kingdom, the National Institute for Health and Care Excellence, which advises on the use of health technologies within the National Health Service, has since at least 2013 used "£ per QALY" to evaluate their utility.

Incremental cost-effectiveness ratio

ICERincremental
When combined with the relative cost of treatment, this information can be used to estimate an incremental cost-effectiveness ratio (ICER), which is considered in relation to NICE's threshold willingness-to-pay value.
This approach has to some extent been adopted in relation to QALYs; for example, the National Institute for Health and Care Excellence (NICE) adopts a nominal cost-per-QALY threshold of £20,000 to £30,000.

Memantine

Namenda
Some of the more controversial NICE decisions have concerned donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and bevacizumab, sorafenib, sunitinib and temsirolimus for renal cell carcinoma.
While memantine can be used in combination with donepezil in those with dementia, the benefit of this is questionable and such dual use is not recommended by the National Institute of Clinical Excellence (NICE).

NHS Wales

WalesNHSNHS in Wales
It serves both the English NHS and the Welsh NHS.
It defending the decision not to set up a Cancer Drugs Fund as in England, on the ground that the fund's own chair has admitted it provides funding for cancer drugs which have 'no impact on survival' and 'uncertainty as to whether quality of life is improved or not' and pointed out that the All-Wales Medicines Strategy Group got new drugs such as Sativex approved for use in Wales more quickly than the National Institute for Health and Care Excellence in England.

Social Care Institute for Excellence

Social Care Institute for Excellence (SCIE)
This is being delivered by the NICE Collaborating Centre for Social Care (NCCSC), which is hosted by the Social Care Institute for Excellence (SCIE) and 4 partner organisations - Research in Practice, Research in Practice for Adults, Personal Social Services Research Unit and the EPPI-Centre.

Karl Claxton

A report from the University of York Centre for Health Economics written by Karl Claxton in February 2015 suggested that the maximum threshold, currently around £30,000 a year, for judging a medicine cost-effective should be more than halved.
He has been a member of the National Institute for Health and Care Excellence Appraisal Committee since 1999.

Health care rationing

healthcare rationingrationingcost-cutting or rationing measure
In the United Kingdom, the National Institute for Health and Care Excellence (NICE) sets coverage requirements for the National Health Service (NHS), which is funded and operated by the government.

Bevacizumab

AvastinMvasi
Some of the more controversial NICE decisions have concerned donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and bevacizumab, sorafenib, sunitinib and temsirolimus for renal cell carcinoma.
In countries with national health care systems (such as the UK and Canada), many of those national health services have restricted bevacizumab on the basis of cost-benefit calculations; in the U.K., for example, the National Institute for Health and Care Excellence has taken the position that bevacizumab should not be funded by the NHS because it costs nearly £21,000 per patient but only minimal benefit in many cancers.

University of York

YorkThe University of YorkYork University
A report from the University of York Centre for Health Economics written by Karl Claxton in February 2015 suggested that the maximum threshold, currently around £30,000 a year, for judging a medicine cost-effective should be more than halved.
It is home to two prominent health economics journals and has been home to many prominent names in health economics (including current Lead Health Economist at the World Bank Adam Wagstaff, ex-deputy chair of NICE Tony Culyer, current ISPOR director Paul Kind, ex-ISPOR president Mike Drummond, current chairman of York Primary Care Trust Alan Maynard).

Sorafenib

NexavarSorafenib tosylate
Some of the more controversial NICE decisions have concerned donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and bevacizumab, sorafenib, sunitinib and temsirolimus for renal cell carcinoma.
In November 2009, the UK's National Institute of Clinical Excellence declined to approve the drug for use within the NHS in England, Wales and Northern Ireland, stating that its effectiveness (increasing survival in primary liver cancer by 6 months) did not justify its high price, at up to £3000 per patient per month.

Sunitinib

Sutentsunitinib malateSU011248
Some of the more controversial NICE decisions have concerned donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease and bevacizumab, sorafenib, sunitinib and temsirolimus for renal cell carcinoma.
In the UK, NICE refused (late 2008) to recommend sunitinib for late-stage renal cancer (kidney cancer) due to the high cost per QALY, estimated by NICE at £72,000/QALY and by Pfizer at £29,000/QALY.