How novel treatment technologies are presented to organisations like NICE for approval is very important. I heard yesterday of one drug company that chose not to go to NICE as their QALY score and NICE cost justification would probably prevent approval. So the Cancer drugs fund has been picking up the tab for this drugs use by clinicians. However with this fund soon going in England there is concern. Here in Wales we are familiar with this issue as we do not have such a fund available.
Gaining NICE approval is going to be even more important in the light of the changes to the cancer drugs fund. As I mentioned in an earlier thread this is available to access licensed drug ahead of approval or if not considered cost effective by NICE. David Cameron is using this as an election issue and pledged to extend this in England
” Prime Minister David Cameron said the CDF had been a "massive success" and added that should he be re-elected he would recommend that it be continued beyond 2016.”
CANCER DRUGS FUND 'TO BE EXTENDED' UNTIL 2016 bbc.co.uk/news/health-24304351
To help people understand how NICE appraise a drug I have posted below information .
Starting with what is most important to NICE the “ QALY “ score
This is about how NICE measure effectiveness and cost effectiveness: the QALY
With the rapid advances in modern medicine, most people accept that no publicly funded healthcare system, including the NHS, can possibly pay for every new medical treatment which becomes available. The enormous costs involved mean that choices have to be made.
It makes sense to focus on treatments that improve the quality and/or length of someone's life and, at the same time, are an effective use of NHS resources.
NICE takes all these factors into account when it carries out its technology appraisals (TAs) on new drugs. Our expert review groups (comprising both health professionals and patients) examine independently-verified evidence on how well a drug works and whether it provides good value for money.
To ensure our judgements are fair, we use a standard and internationally recognised method to compare different drugs and measure their clinical effectiveness: the quality-adjusted life years measurement (the ‘QALY').
HOW IS THIS CALCULATED?
Although one treatment might help someone live longer, it might also have serious side effects. (For example, it might make them feel sick, put them at risk of other illnesses or leave them permanently disabled.) Another treatment might not help someone to live as long, but it may improve their quality of life while they are alive (for example, by reducing their pain or disability).
The QALY method helps us measure these factors so that we can compare different treatments for the same and different conditions. A QALY gives an idea of how many extra months or years of life of a reasonable quality a person might gain as a result of treatment (particularly important when considering treatments for chronic conditions).
A number of factors are considered when measuring someone's quality of life, in terms of their health. They include, for example, the level of pain the person is in, their mobility and their general mood. The quality of life rating can range from negative values below 0 (worst possible health) to 1 (the best possible health). (See the box below for an example of how this works in practice.)
WHAT ABOUT COST EFFECTIVENESS?
Having used the QALY measurement to compare how much someone's life can be extended and improved, we then consider cost effectiveness - that is, how much the drug or treatment costs per QALY. This is the cost of using the drugs to provide a year of the best quality of life available - it could be one person receiving one QALY, but is more likely to be a number of people receiving a proportion of a QALY - for example 20 people receiving 0.05 of a QALY.
Cost effectiveness is expressed as ‘£ per QALY'.
Each drug is considered on a case-by-case basis. Generally, however, if a treatment costs more than £20,000-30,000 per QALY, then it would not be considered cost effective