National Institute for Health and Care Excellence

373: 266: 913:(PCTs) in providing treatments not assessed by NICE, which tends to be lower. Some witnesses, including patient organisations and pharmaceutical companies, thought NICE should be more generous in the cost per QALY threshold it uses, and should approve more products. On the other hand, some PCTs struggle to implement NICE guidance at the current threshold and other witnesses argued that a lower level should be used. However, there are many uncertainties about the thresholds used by PCTs." It went on to recommend that "an independent body should determine the threshold used when making judgements of the value of drugs to the NHS." 604:

report to produce an evaluation report. An independent Appraisal Committee then looks at the evaluation report, hears spoken testimony from clinical experts, patient groups and carers. They take their testimony into account and draw up a document known as the 'appraisal consultation document'. This is sent to all consultees and commentators who are then able to make further comments. Once these comments have been taken into account the final document is drawn up called the 'final appraisal determination'. This is submitted to NICE for approval.

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treatment will cost the NHS more than three times as much at £10,000. Patients score their perceived quality of life on a scale from 0 to 1 with 0 being worst possible health and 1 being best possible health. On the standard treatment, quality of life is rated with a score of 0.4 but it improves to 0.6 with the new treatment. Patients on the new treatment on average live an extra 3 months, so 1.25 years in total. The quality of life gained is the product of

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aimed at aligning professional standards through clinical guidelines and audit, the acceptability of drugs, devices and technological interventions in defining those standards, could not be ignored and so the concept of a "fourth hurdle" for drugs accessing the NHS market was invoked. This controversial policy shift meant that NICE was critical for decisions on drug reimbursement. Indeed, the first drug appraisal by NICE was on the drug

376: 675: 84: 43: 781:. Drawing on the expertise of SCIE and their partners within the sector, each of the guidance products and quality standards had a needs assessment carried out to determine the requirements for tools to help embed the guidance and quality standards within the sector. These could include tailored versions of guidance for specific audiences, costing and commissioning tools and even training and learning packages. 377: 186: 774:

standing committees to develop a quality standard on the topic. The quality standard was developed using the guidance and other accredited sources, to produce high-level concise statements that can be used for quality improvement by social care providers and commissioners, as well as setting out what service users and carers can expect of high quality social care services.

638:

and ensures that these comments have been taken into account. The Guideline Development Group then finalises the recommendations and the National Collaboration Centre produces the final guideline. This is submitted to NICE to formally approve the guideline and issue the guidance to the NHS. To date NICE has produced more than 200 different guidelines.

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explicit determination of cost–benefit boundaries for certain technologies that it assesses. NICE also plays an important role in pioneering technology assessment in other healthcare systems through NICE International, established in May 2008 to help cultivate links with foreign governments. NICE International has received financial support from the

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The National Collaborating Centre appoints a Guideline Development Group whose job it is to work on the development of the clinical guideline. This group consists of medical professionals, representatives of patient and carer groups and technical experts. They work together to assess the evidence for

505:

informed policy making on what national screening programmes were approved for funding and what quality assurance mechanisms should be in place. This was a timely action as screening quality in breast cancer screening services came under question at Exeter in 1997 and followed in the wake of the 1995

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established 22 Operational Delivery Networks to roll out delivery and proposes to fund 10,000 courses of treatment in 2016-17. Each has been given a “run rate” of how many patients they are allowed to treat. This is the NHS’ single biggest new treatment investment this year. In the North East London

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could still decide to fund the new treatment, but if not, the patient would then have two choices. He or she could opt to take the free NHS standard treatment, or he or she may decide to pay out of pocket to obtain the benefit of the new treatment from a different health care provider. If the person

840:

As a guideline rule, NICE accepts as cost-effective those interventions with an incremental cost-effectiveness ratio of less than £20,000 per QALY and that there should be increasingly strong reasons for accepting as cost-effective interventions with an incremental cost-effectiveness ratio of over a

637:

of competing products) before preparing a draft guideline. There are then two consultation periods in which stakeholder organisations are able to comment on the draft guideline. After the second consultation period, an independent Guideline Review Panel reviews the guideline and stakeholder comments

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has been legally obliged to provide funding for medicines and treatments recommended by NICE's technology appraisal board. This was at least in part as a result of well-publicised postcode lottery anomalies in which certain less-common treatments were funded in some parts of the UK but not in others

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A Conservative shadow minister once criticized NICE for spending more on communications than assessments. In its defence, NICE said the majority of its communications budget was spent informing doctors about which drugs had been approved and new guidelines for treatments and that the actual cost of

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A statement published by the Royal College of Physicians expressed concern that the 2021 NICE guidelines for ME/CFS did not properly evaluate or recommend graded exercise therapy and cognitive behavioral therapy for the treatment of ME/CFS. A study by 49 academics argued that the dissonance between

812:

associated with their decisions. By choosing to spend the finite NHS budget upon those treatment options that provide the most efficient results, society can ensure it does not lose out on possible health gains through spending on inefficient treatments and neglecting those that are more efficient.

624:

NICE has set up several National Collaborating Centres bringing together expertise from the royal medical colleges, professional bodies and patient/carer organisations which draw up the guidelines. The centres are the National Collaborating Centre for Cancer, the National Clinical Guideline Centre,

546:

in February 1999 where questions were raised as to whether NICE was just a means to "ration" healthcare. Sir Michael Rawlins and Timothy Riley presented a compelling case that positioned NICE as a standards setting body first and foremost. However, the reality was that although NICE was principally

901:

In practice this exercise is not done, but an assumed shadow price has been used by NICE for many years in its assessments to determine which treatments the NHS should and should not fund. NICE states that for drugs the CQG should not normally exceed £30,000 but that there is not a hard threshold,

816:

NICE attempts to assess the cost–effectiveness of potential expenditures within the NHS to assess whether or not they represent 'better value' for money than treatments that would be neglected if the expenditure took place. It assesses the cost–effectiveness of new treatments by analysing the cost

603:

An independent academic centre then draws together and analyses all of the published information on the technology under appraisal and prepares an assessment report. This can be commented on by the Consultees and Commentators. Comments are then taken into account and changes made to the assessment

921:

The work that NICE is involved in, attracts the attention of many groups, including doctors, the pharmaceutical industry, and patients. NICE is often associated with controversy, because the requirement to make decisions at a national level, can conflict with what is (or is believed to be) in the

909:, in its report on NICE, stated in 2008 that "the ... cost-per-QALY it uses to decide whether a treatment is cost-effective is of serious concern. The threshold it employs is not based on empirical research and is not directly related to the NHS budget, nor is it at the same level as that used by 876:

with the new treatment less the same calculation for the old treatment, i.e. (1.25 x 0.6) less (1.0 x 0.4) = 0.35 QALY. The marginal cost of the new treatment to deliver this extra gain is £7,000 so the cost per quality life year gained is £7000/0.35 or £20,000. This is within the £20,000-£30,000

893:

Theoretically, it might be possible to draw up a table of all possible treatments sorted by cost per QALY gained. Those treatments with lowest cost per QALY gained would appear at the top of the table and deliver the most benefit per value spent and would be easiest to justify funding for. Those

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of 13 medicines recommended for asthma, kidney disease, stroke prevention and type 2 diabetes. They found that 1.2 million patients had not received the drugs which could have given them the equivalent of 429,000 extra years in “complete good health” which could have translated into £17.9bn in

468:

of healthcare in England and Wales, where availability of treatments depended on the NHS Health Authority area in which the patient happened to live, but it has since acquired a high reputation internationally as a role model for the development of clinical guidelines. One aspect of this is the

645:

said that a Labour government could reduce variation in access to drugs and procedures by making it mandatory for commissioners to follow NICE clinical guidelines. "We need to look at how you strengthen NICE. Where they have said something is effective and affordable, on what basis does a local

933:

are funded by the NHS without any financial contribution being taken from the patient. Where NICE has approved a treatment, the NHS must fund it. But not all treatments have been assessed by NICE and these treatments are usually dependent on local NHS decision making. In the case of cancer the

773:

The Guidance Development Group then finalised the recommendations and the NCCSC produced the final guideline. This was submitted to NICE for formal approval and publication. The entire process from pre-scoping to publication took approximately 24 months. The guidance was then available to NICE

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A patient has a life-threatening condition and is expected to live on average for one year receiving the current best treatment which costs the NHS £3,000. A new drug becomes available that will extend the life of the patient by three months and improve his or her quality of life, but the new

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appraisal and comment on the appraisal documents. Commentator organisations include the manufacturers of products to which the product undergoing appraisal is being compared. They comment on the documents that have been submitted and drawn up but do not actually submit information themselves.

599:

NICE then invites consultee and commentator organisations to take part in the appraisal. A consultee organisation would include patient groups, organisations representing health care professionals and the manufacturers of the product undergoing appraisal. Consultees submit evidence during the

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has a private health insurance policy the person could check to see whether the private insurance provider will fund the new treatment. About 8% of the population has some private health insurance from an employer or trade association and 2% pay from their own resources.

894:

where the delivered benefit is low and the cost is high would appear at the bottom of the list. Decision makers would, theoretically, work down the table, adopting services that are the most cost effective. The point at which the NHS budget is exhausted would reveal the

620:

NICE carries out assessments of the most appropriate treatment regimes for different diseases. This must take into account both desired medical outcomes (i.e. the best possible result for the patient) and also economic arguments regarding differing treatments.

833:) of expected QALY flows with and without treatment, or relative to another treatment, the net/relative health benefit derived from such a treatment can be derived. When combined with the relative cost of treatment, this information can be used to estimate an 611:

by pharmaceutical companies to mobilise media attention and influence public opinion are attempts to influence the decision-making process. A fast-track assessment system has been introduced to reach decisions where there is most pressure for a conclusion.

555:

that the appraisal had been fast tracked. 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

1013:

assessing new drugs for the NHS includes money spent on NICE's behalf by the Department of Health. When these were added to NICE's own costs, the total cost of the technology appraisal programme far outstrips the cost of NICE communications.

844:

Over the years, there has been great controversy as to what value this threshold should be set at. Initially, there was no fixed number. But the appraisal teams created a consensus amount of about £30,000. However, in November 2008

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that are already approved for use in the NHS. However the Department of Health said that it had 'made it clear to PCTs that funding for treatments should not be withheld simply because guidance from NICE is unavailable'.

1024:

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. They found that any intervention costing more than £13,000 per

3144: 534:, The New NHS: Modern, Dependable 1997. Timothy Riley led the team that developed the policy and for NICE and which managed the legislation through Parliament in addition to implementing the new institute as a 530:. The name and mission was agreed in a meeting between the Ministerial team, Timothy Riley and Felicity Harvey shortly after the election and it was agreed that NICE should be described in the first policy 1468: 517:

became Secretary of State and was supported by a team of Ministers keen on introducing clinical and health outcome measures to achieve improvements in the quality and delivery of care. The team included

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must then refer any technology so that the appraisal process can be formally initiated. Once this has been done NICE works with the Department of Health to draw up the scope of the appraisal.

649:

NICE has a service called Clinical Knowledge Summaries (CKS) which provides primary care practitioners with a readily accessible summary of the current evidence base and practical guidance.

770:

to take place, thus delivering the guidance and subsequent recommendations. Service user and carer involvement took place throughout, as well as public consultation on the draft guidance.

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was set up in 2011 after complaints about NICE decisions on new and expensive cancer drugs with limited benefits. Treatment for fertility problems are approved but not always funded by

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The NCCSC is unique within NICE, in that it is the only collaborating centre to have responsibility for the adoption and dissemination support for guidance and quality standards in the

696: 101: 56: 1472: 1365: 800:

As with any system financing health care, the NHS has a limited budget and a vast number of potential spending options. Choices must be made as to how this limited budget is spent.

2222: 1001:

the 2021 guidelines and the previous guideline was the result of deviating from usual scientific standards of the NICE process. NICE responded that they did follow the standard

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with a scoping group and with input from key stakeholders, at both a workshop and a public consultation, to ensure the guidance to be produced was focused and achievable. A

3256: 17: 2394: 997:. All these are drugs with a high cost per treatment and NICE has either rejected or restricted their use in the NHS on the grounds that they are not cost-effective. 898:, the threshold lying between the CQG (cost per QALY gained) of the last service that is funded and that of the next most cost effective service that is not funded. 2252: 1437: 607:

The process aims to be fully independent of government and lobbying power, basing decisions fully on clinical and cost-effectiveness. There have been concerns that

2721: 751:. Over a five year period, the NCCSC developed social care guidelines and supported the implementation of both the guidelines and social care quality standards. 457:, 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 2372: 148: 62: 120: 398: 3124: 1278: 2612: 829:(QALY) as the primary outcome for quantifying the expected health benefits associated with a given treatment regime. By comparing the present value (see 127: 3206: 2537: 657: 588:

Before an appraisal, the Advisory Committee on Topic Selection (ACTS) draws up a list of potential topics of clinical significance for appraisal. The

3129: 2810: 2268:"Anomalies in the review process and interpretation of the evidence in the NICE guideline for chronic fatigue syndrome and myalgic encephalomyelitis" 1381: 2731: 134: 3236: 3226: 2914: 2889: 2772: 1075: 788:, older adults with long-term conditions, transition between health and social care settings, transition from children's to adults' services and 626: 880:

If the patient was expected to live only one month extra and instead of three then NICE would issue a recommendation not to fund. The patient's

3246: 1985: 2424: 747:(SCIE) and four partner organisations - Research in Practice, Research in Practice for Adults, Personal Social Services Research Unit and the 116: 2569: 2530: 1841: 1917: 3241: 2690: 2043:"Final appraisal determination: Lenalidomide for the treatment of multiple myeloma in people who have received at least one prior therapy" 1363: 2042: 3261: 3119: 2230: 2196: 2594: 2561: 489:'s Conservative Government as moves elsewhere were being made to set professionally agreed standards for clinical care. In 1997, the 513:

The idea of what was originally called the National Institute for Clinical Excellence took root when Labour came to power in 1997.

2226: 946: 523: 3231: 2094: 2579: 141: 3134: 2803: 2460: 1901: 1874: 1224: 1112: 2176:"House of Commons Health Committee: National Institute for Health and Clinical Excellence - First Report of Session 2007-08" 1469:"National Institute for Health and Clinical Excellence (NICE): How does it work and what are the implications for the U.S.?" 1251: 743:, using an evidence-based model. This was delivered by the NICE Collaborating Centre for Social Care (NCCSC), hosted by the 3165: 2553: 1574:"National Institute for Health and Clinical Excellence (NICE). How does it work and what are the implications for the U.S?" 849:, the then Secretary of State, announced that for end-of-life cancer drugs the threshold could be increased above £30,000. 834: 744: 346: 2127:"Does NICE have a cost effectiveness threshold and what other factors influence its decisions? A discrete choice analysis" 1445: 1344: 1187: 1161: 1135: 1057:

start treatment each month. Those without such complications may faced considerable delays before they start treatment.

501:(now Sir Muir Gray) by the Policy Team led by Timothy Riley for the Department of Health. The NSC aimed to ensure that 470: 2726: 2574: 2363: 2014: 722: 410: 243: 225: 167: 70: 704: 3149: 2796: 2747: 2469: 1397: 1216: 1573: 864:

The following example from NICE explains the QALY principle and the application of the cost per QALY calculation.

420:

clinical practice (guidance on the appropriate treatment and care of people with specific diseases and conditions)

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Rasul, Nazia; Malik, Muhammad Sohail Anwar; Bakhtawar, Beenish; Thaheem, Muhammad Jamaluddin (2 November 2021).

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The notion of an Institute to determine the clinical effectiveness of interventions first emerged at the end of

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though research has shown that any threshold is "somewhat higher" than being in the range £35,000 - £40,000.

589: 3216: 3029: 2993: 2627: 939: 805: 535: 458: 394: 1627:"Decision making in NICE single technological appraisals: How does NICE incorporate patient perspectives?" 2988: 2864: 2777: 2417:"Philip Christopher Baldwin: "We need better access to treatment for gay men living with HIV and Hep C"" 3266: 2924: 2884: 1104:

National Institute for Health and Clinical Excellence: Eighth Report of Session 2012-13, Vol. 1: Report

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and members of the Guidance Development Group were appointed, and posed review questions which enabled

1158:"The National Institute for Clinical Excellence (Establishment and Constitution) Amendment Order 2005" 3221: 2939: 2934: 2894: 2859: 2685: 2617: 2161: 2081: 1996: 1500: 817:

and benefit of the proposed treatment relative to the next best treatment that is currently in use.

265: 3008: 2879: 2869: 2654: 2644: 1986:"NICE Guideline Manual: Incorporating health economics in guidelines and assessing resource impact" 755: 685: 203: 3093: 2919: 2904: 2833: 2819: 2680: 2267: 2133: 906: 789: 689: 543: 502: 94: 1210: 646:

commissioner withhold that from somebody? I’m not comfortable with that. I don’t support that."

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A Terrible Beauty: A Short History of NICE The National Institute of Health and Care Excellence

1415: 974: 653: 474: 2049: 1891: 2959: 2929: 2874: 2838: 2148: 2068: 1816: 1487: 1100: 1066: 1054: 31: 1864: 1516:"Postcode Lotteries in Public Health - The NHS Health Checks Programme in North West London" 1129:"The National Institute for Clinical Excellence (Establishment and Constitution) Order 1999" 1102: 949:

said it was outraged over its delayed decision for further guidance regarding two drugs for

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Health Technology Assessments by the National Institute for Health and Clinical Excellence

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risked causing more harm than good by denying cost effective treatment to other patients.

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framework to compare the cost-effectiveness of alternative activities and to consider the

8: 3088: 2716: 801: 1128: 758:, and commission the guidance from the NCCSC. NICE, along with the NCCSC, carried out a 3145:

Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)

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As of August 2013, NICE and the NCCSC had scheduled guidance delivery for five topics:

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NICE received referrals for social care guidance from the Department of Health and the

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go to the front of the queue and three new patients at the Grahame Hayton Unit at the

837:(ICER), which is considered in relation to NICE's threshold willingness-to-pay value. 3013: 2973: 2456: 2344: 2336: 2299: 2287: 1897: 1870: 1780: 1762: 1709: 1664: 1646: 1600: 1555: 1537: 1220: 1108: 945:

NICE has been criticised for being too slow to reach decisions. On one occasion, the

935: 767: 406: 2590:

Parliamentary Under-Secretary of State for Mental Health and Women's Health Strategy

2315:"NICE guideline on ME/CFS: robust advice based on a thorough review of the evidence" 1966:

Methods for the Economic Evaluation of Health Care Programmes, Drummond et al (2005)

2604: 2326: 2279: 1770: 1752: 1741:"Factors affecting therapeutic compliance: A review from the patient's perspective" 1721: 1654: 1638: 1545: 1527: 809: 465: 424: 1725: 739:, NICE was given responsibility for developing guidance and quality standards for 3045: 3018: 2983: 2491: 1369: 1256: 1247: 539: 438:

evaluations of efficacy, safety and cost-effectiveness in various circumstances.

303: 2503:: "What is the NICE threshold?", Centre for Health Economics, University of York 1683: 1183: 1157: 564:. As of 1 February 2022, its chief executive is Samantha Roberts, who succeeded 202:

The references used may be made clearer with a different or consistent style of

3065: 3003: 2968: 2664: 1438:"Dr Samantha Roberts starts work as NICE CEO today. | News and features | News" 1002: 759: 634: 593: 561: 552: 494: 435: 207: 2500: 3200: 3055: 3050: 2978: 2340: 2331: 2283: 2253:"Medical leaders sign joint statement in response to NICE guidance on ME/CFS" 1766: 1650: 1604: 1541: 1532: 557: 2998: 2944: 2450: 2348: 2313:

Barry, Peter Walter; Kelley, Kate; Tan, Toni; Finlay, Ilora (1 July 2024).

2291: 2019: 1784: 1668: 1559: 1021: 990: 966: 930: 926: 895: 853: 846: 642: 625:

the National Collaborating Centre for Women and Children´s Health, and the

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that is suggested by NICE to be the limit for drugs to be cost-effective.

417:(such as the use of new and existing medicines, treatments and procedures) 3181: 3024: 2949: 2659: 1041: 1033: 978: 962: 830: 778: 748: 740: 577: 531: 318: 2314: 1514:

Graley, Clare EM; May, Katherine F; McCoy, David C (28 September 2011).

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Parliamentary Under-Secretary of State for Public Health and Prevention

1757: 1037: 486: 441:

It serves both the English NHS and the Welsh NHS. It was set up as the

1642: 1466: 1322: 1101:

Great Britain: Parliament: House of Commons: Health Committee (2013).

2395:"NHS England rollout of ground-breaking drugs 'changes role of NICE'" 1046: 1040:

was approved in 2015. It costs about £30,000 for 12 weeks treatment.

1032:

The institute's approach to the introduction of new oral therapy for

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NICE put on defensive as ruling on Relenza ends in row over 'leaks'

674: 83: 1889: 1050: 763: 608: 1710:"Risk assessment of fast-track projects: a systems-based approach" 27:

Non-departmental public body of the Department of Health in the UK

1939: 1349: 548: 3252:

Non-departmental public bodies of the United Kingdom government

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Timmins, Nicholas; Rawlins, Sir Michael; Appleby, John (2016).

1625:

Hashem, Ferhana; Calnan, Michael W.; Brown, Patrick R. (2018).

321:, Minister of State at the Department of Health and Social Care 300: 1962: 1960: 957:

Some of the more controversial NICE decisions have concerned

859: 3125:

Canadian Agency for Drugs and Technologies in Health (CADTH)

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Measuring effectiveness and quality effectiveness - the QALY

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Jin, J.; Sklar, G. E.; Min Sen Oh, V.; Chuen Li, S. (2008).

2495: 1957: 1918:"The Primer: Hunt's fix for 'rogue system' of NHS and DHSC" 2100: 1738: 1707: 2515: 357: 3140:

National Institute for Health and Care Excellence (NICE)

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NICE was established in an attempt to end the so-called

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with subjective outcomes was appropriately downgraded.

1842:"Exclusive: Labour could make NICE guidance mandatory" 2448: 1184:"The Special Health Authorities Abolition Order 2005" 1084: – National healthcare organisation for Scotland 461:

to an executive non-departmental public body (NDPB).

451:

National Institute for Health and Clinical Excellence

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The Unbearable Cost of Living, Sunday Times (London)

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Pages displaying wikidata descriptions as a fallback

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Organisations based in the London Borough of Newham

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Medicines and Healthcare products Regulatory Agency

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Journal of Neurology, Neurosurgery & Psychiatry

2265: 2197:"NHS IVF and Fertility Treatment – Funding Options" 1940:"NICE Collaborating Centre for Social Care (NCCSC)" 542:(the then recently appointed Chair of NICE) at the 117:"National Institute for Health and Care Excellence" 108:. Unsourced material may be challenged and removed. 2722:Review Body on Doctors' and Dentists' Remuneration 2362: 2272:Journal of Neurology, Neurosurgery, and Psychiatry 1467:Sorenson, C; Drummond, M; Kanavos, P; McGuire, A. 658:Association of the British Pharmaceutical Industry 3120:Agency for Healthcare Research and Quality (AHRQ) 2701:National Institute for Health and Care Excellence 2595:Parliamentary Under-Secretary of State for Health 1624: 1398:"House of Commons - Health - Minutes of Evidence" 1286:National Institute for Health and Care Excellence 1279:"Annual General Meeting and Public Board Meeting" 852:The first drug to go through the new process was 387:National Institute for Health and Care Excellence 259:National Institute for Health and Care Excellence 3198: 2732:Advisory Committee on Clinical Excellence Awards 1890:Judith A Rees; Ian Smith; Jennie Watson (2014). 1714:International Journal of Construction Management 381:A six-minute video documentary of NICE from 2008 329:Executive non-departmental public body executive 2915:Evidence-based pharmacy in developing countries 2890:Evidence-based library and information practice 2773:National Institute for Health and Care Research 2040: 1076:National Institute for Health and Care Research 627:National Collaborating Centre for Mental Health 273:Executive non-departmental public body overview 3150:WHO Evidence-Informed Policy Network (EVIPNet) 2012: 1513: 820: 661:“productivity gains” for the British economy. 2804: 2570:Secretary of State for Health and Social Care 2538: 2475:The Price of Life, BBC Documentary about NICE 2199:. Hfea.gov.uk. 6 January 2015. Archived from 2097:National Institute for clinical effectiveness 1883: 925:Approved cancer drugs and treatments such as 551:which was turned down amidst criticisms from 445:in 1999, and on 1 April 2005 joined with the 3135:German Agency for Quality in Medicine (AEZQ) 2691:Human Fertilisation and Embryology Authority 1896:. Elsevier Health Sciences UK. p. 192. 1094: 430:guidance for social care services and users. 2818: 2364:"Expensive drugs cost lives, claims report" 2015:"Johnson lifts NHS ban on top-up treatment" 1862: 888: 703:. Unsourced material may be challenged and 453:(still abbreviated as NICE). Following the 401:, that publishes guidelines in four areas: 71:Learn how and when to remove these messages 30:"NICE" redirects here. For other uses, see 2811: 2797: 2545: 2531: 2013:Boseley, S; Sparrow, A (4 November 2008). 1430: 860:Cost per quality-adjusted life year gained 443:National Institute for Clinical Excellence 264: 18:National Institute for Clinical Excellence 3207:1999 establishments in the United Kingdom 2330: 1856: 1844:. Health Service Journal. 30 October 2014 1774: 1756: 1745:Therapeutics and Clinical Risk Management 1658: 1549: 1531: 1208: 922:best interests of an individual patient. 723:Learn how and when to remove this message 585:due to local decision making in the NHS. 244:Learn how and when to remove this message 226:Learn how and when to remove this message 168:Learn how and when to remove this message 2227:Royal National Institute of Blind People 2124: 947:Royal National Institute of Blind People 907:House of Commons Health Select Committee 571: 434:These appraisals are based primarily on 371: 1020:Centre for Health Economics written by 942:and they may cap the number of rounds. 664: 14: 3237:Health in the London Borough of Newham 3227:Health education in the United Kingdom 3199: 2397:. Health Service Journal. 4 April 2016 1590: 615: 423:guidance for public sector workers on 3247:National agencies for drug regulation 2792: 2526: 2470:NICE annual conference and exhibition 2375:from the original on 10 December 2022 1920:. Health Service Journal. 16 May 2022 1246: 795: 3166:Centre for Reviews and Dissemination 2554:Department of Health and Social Care 1866:Guide to the Primary Care Guidelines 1681: 1295:from the original on 21 January 2022 1107:. The Stationery Office. p. 7. 835:incremental cost-effectiveness ratio 745:Social Care Institute for Excellence 701:adding citations to reliable sources 668: 399:Department of Health and Social Care 347:Department of Health and Social Care 179: 106:adding citations to reliable sources 77: 36: 3242:Health policy in the United Kingdom 1869:. Radcliffe Publishing. p. 6. 1684:"Herceptin: Was patient power key?" 1591:Butler, Patrick (9 November 2000). 1188:Office of Public Sector Information 1162:Office of Public Sector Information 1136:Office of Public Sector Information 560:, Trevor Gibbs, Timothy Riley, and 471:Bill & Melinda Gates Foundation 24: 2442: 825:NICE guidance supports the use of 25: 3278: 3262:Organizations established in 1999 2727:Independent Reconfiguration Panel 2580:Minister of State for Social Care 2507: 1427:Milbank Quarterly, September 2001 1069: – facet of health economics 480: 411:England's National Health Service 52:This article has multiple issues. 2748:British Pharmacopoeia Commission 673: 184: 82: 41: 2650:NHS Business Services Authority 2409: 2387: 2355: 2306: 2266:White, P.; et al. (2023). 2259: 2245: 2229:. 8 August 2007. Archived from 2215: 2189: 2168: 2118: 2088: 2034: 2006: 1978: 1969: 1932: 1910: 1834: 1809: 1791: 1732: 1701: 1675: 1618: 1584: 1566: 1507: 1473:National Pharmaceutical Council 1460: 1444:. February 2022. Archived from 1421: 1408: 1390: 1383:The New NHS: Modern, Dependable 1374: 1357: 1350:Parliamentary Debates (Hansard) 1217:Springer Science+Business Media 1082:Healthcare Improvement Scotland 841:threshold of £30,000 per QALY. 737:Health and Social Care Act 2012 576:Since January 2005, the NHS in 491:UK National Screening Committee 455:Health and Social Care Act 2012 93:needs additional citations for 60:or discuss these issues on the 3232:Health education organizations 2223:"Media release (14 June 2007)" 1337: 1307: 1271: 1240: 1202: 1176: 1150: 1121: 493:(NSC) had been established by 13: 1: 2900:Evidence-based medical ethics 2753:Commission on Human Medicines 2423:. 11 May 2016. Archived from 2048:. nice.org.uk. Archived from 1726:10.1080/15623599.2019.1602587 1682:Berg, Sanchia (9 June 2006). 1088: 940:clinical commissioning groups 590:Secretary of State for Health 3030:Policy-based evidence making 2994:Health technology assessment 2575:Minister of State for Health 916: 806:health technology assessment 395:non-departmental public body 335:Sam Roberts, Chief Executive 7: 2989:Randomized controlled trial 2865:Evidence-based conservation 2778:NHS Counter Fraud Authority 1593:"Q&A: Postcode lottery" 1209:Schlander, Michael (2007). 1060: 827:quality-adjusted life years 821:Quality-adjusted life years 768:systematic evidence reviews 283:; 25 years ago 10: 3283: 2925:Evidence-based prosecution 2885:Evidence-based legislation 2183:publications.parliament.uk 1027:quality-adjusted life year 856:, whose ICER was £43,800. 633:the guideline topic (e.g. 29: 3174: 3158: 3112: 3081: 3074: 3038: 2958: 2940:Evidence-based toxicology 2935:Evidence-based scheduling 2895:Evidence-based management 2860:Evidence-based assessment 2847: 2826: 2765: 2740: 2709: 2686:Health Research Authority 2673: 2637: 2626: 2618:UK Health Security Agency 2603: 2560: 1728:– via ResearchGate. 1345:"Breast Cancer Screening" 804:are carried out within a 447:Health Development Agency 352: 342: 328: 311: 295: 277: 272: 263: 3009:Pragmatic clinical trial 2880:Evidence-based education 2870:Evidence-based dentistry 2655:NHS Blood and Transplant 2645:Health Education England 2332:10.1136/jnnp-2023-332731 2284:10.1136/jnnp-2022-330463 1533:10.1186/1471-2458-11-738 1368:January 3, 2011, at the 889:Basis of recommendations 756:Department for Education 536:Special Health Authority 459:special health authority 427:and ill-health avoidance 2920:Evidence-based policing 2905:Evidence-based medicine 2834:Evidence-based practice 2820:Evidence-based practice 2681:Care Quality Commission 2134:City University, London 1893:Pharmaceutical Practice 1386:. Department of Health. 1315:"History of the UK NSC" 790:child abuse and neglect 544:Health Select Committee 538:. Timothy Riley joined 503:evidence-based medicine 3104:Science-Based Medicine 3099:Campbell Collaboration 3094:Cochrane Collaboration 2910:Evidence-based nursing 2696:Human Tissue Authority 2485:NICE Annual Conference 2156:Cite journal requires 2125:Devlin, N; Parkin, D. 2076:Cite journal requires 1495:Cite journal requires 1416:Health Service Journal 1045:network patients with 654:PricewaterhouseCoopers 475:Rockefeller Foundation 382: 3212:Clinical pharmacology 2930:Evidence-based policy 2875:Evidence-based design 2839:Hierarchy of evidence 2605:UK executive agencies 2490:9 August 2020 at the 2041:Appraisal Committee. 2002:on 25 September 2011. 1250:(15 September 2009). 1067:Health care rationing 1055:Royal London Hospital 1036:has been criticised. 973:for the treatment of 572:Technology appraisals 524:Baroness Margaret Jay 397:, in England, of the 380: 32:NICE (disambiguation) 2371:. 19 February 2015. 1863:Peter Smith (2008). 1005:, and evidence from 995:renal cell carcinoma 951:macular degeneration 802:Economic evaluations 697:improve this section 665:Social care guidance 656:did a study for the 312:Minister responsible 102:improve this article 3217:Health care quality 3089:James Lind Alliance 2717:NHS Pay Review Body 2501:Video, 9:19 minutes 1975:NICE guidance, 2008 1631:Health Expectations 975:Alzheimer's disease 911:primary care trusts 616:Clinical guidelines 540:Sir Michael Rawlins 407:health technologies 260: 2855:Effective altruism 2710:England advisories 2638:England executives 2255:. 29 October 2021. 2203:on 27 January 2013 1758:10.2147/tcrm.s1458 1448:on 2 February 2022 1325:on 9 November 2013 1018:University of York 1016:A report from the 882:primary care trust 796:Cost–effectiveness 508:Calman-Hine Report 495:Sir Kenneth Calman 449:to become the new 393:) is an executive 383: 258: 3267:Stratford, London 3194: 3193: 3190: 3189: 3014:Spaced repetition 2974:Systematic review 2786: 2785: 2761: 2760: 2462:978-616-11-2821-0 2278:(12): 1056–1063. 2225:(Press release). 1903:978-0-7020-5282-8 1876:978-1-85775-734-7 1720:(11): 1099–1114. 1643:10.1111/hex.12594 1520:BMC Public Health 1226:978-0-387-71995-5 1186:(Press release). 1160:(Press release). 1138:. 2 February 1999 1134:(Press release). 1114:978-0-215-05239-1 936:Cancer Drugs Fund 779:social care arena 733: 732: 725: 562:Trevor A. Sheldon 378: 370: 369: 343:Parent department 254: 253: 246: 236: 235: 228: 178: 177: 170: 152: 75: 16:(Redirected from 3274: 3222:Health economics 3079: 3078: 2813: 2806: 2799: 2790: 2789: 2635: 2634: 2628:Non-departmental 2547: 2540: 2533: 2524: 2523: 2519: 2518: 2516:Official website 2496:i2i events group 2466: 2437: 2436: 2434: 2432: 2413: 2407: 2406: 2404: 2402: 2391: 2385: 2384: 2382: 2380: 2366: 2359: 2353: 2352: 2334: 2310: 2304: 2303: 2263: 2257: 2256: 2249: 2243: 2242: 2240: 2238: 2219: 2213: 2212: 2210: 2208: 2193: 2187: 2186: 2180: 2172: 2166: 2165: 2159: 2154: 2152: 2144: 2142: 2140: 2131: 2122: 2116: 2115: 2104: 2098: 2092: 2086: 2085: 2079: 2074: 2072: 2064: 2062: 2060: 2055:on 27 March 2012 2054: 2047: 2038: 2032: 2031: 2029: 2027: 2010: 2004: 2003: 2001: 1995:. 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