Making sure new drugs and treatments are distributed equally and consistently

We published 32 technology appraisals on a range of conditions, the majority of which contained positive recommendations for use in the NHS.

NICE technology appraisals aim to ensure equal, and consistent access to new and existing medicines and treatments deemed clinically and cost effective for use in the NHS.

This year, we published 32 technology appraisals on a range of diseases and conditions that include prostate cancer, idiopathic pulmonary fibrosis and non-Hodgkin’s lymphoma. The majority of these appraisals contained positive recommendations for use in the NHS.

In April 2013, we published guidance which recommends pirfenidone (Esbriet, manufactured by InterMune) for certain people who have the lung condition idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis is a lung condition that causes scarring of the lungs, gets worse over time and is often fatal.

Pirfenidone aims to slow down the irreversible damage in the lungs caused by idiopathic pulmonary fibrosis. The drug is an oral capsule taken three times a day.

In final guidance, we recommended pirfenidone as a treatment option across the NHS for people with idiopathic pulmonary fibrosis who have a forced vital capacity (FVC) between 50% and 80% predicted - FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible.

NICE estimates that around 6,800 people in England and Wales with idiopathic pulmonary fibrosis could be eligible for treatment in line with its recommendations.

We also published guidance that recommends treatments for fractured bones in the spine caused by osteoporosis.

The guidance said that percutaneous vertebroplasty and percutaneous balloon kyphoplasty are recommended as options for treating osteoporotic vertebral compression fractures only in people:

  • who have severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management, and
  • in whom the pain has been confirmed to be at the level of the fracture by physical examination and imaging.

Professor Carole Longson, Director of the Centre for Health Technology Evaluation at NICE, commented: “This new technology appraisal guidance highlights that as these procedures provide benefits to patients and value for money, they ought to be offered to patients when appropriate.”

In February 2014, we recommended aflibercept solution (Eylea, Bayer) for injection as an option for treating visual impairment caused by macular oedema. This is a condition that affects a person’s ability to see detail and colour.

The guidance relates to macular oedema secondary to central retinal vein occlusion (CRVO), where the vein to the retina is blocked. NICE recommends the treatment is only prescribed if the manufacturer makes it available to the NHS under terms agreed with the Department of Health as part of a patient access scheme.

Professor Carole Longson, said: "Macular oedema can have a significant impact on the independence and day-to-day life for people with the condition, affecting their ability to work, drive, and take part in hobbies such as reading and going to the cinema.

“Therefore NICE is pleased to recommend aflibercept solution as another clinically and cost-effective treatment option for people with macular oedema caused by central retinal vein occlusion as well as ranibizumab and dexamethasone, which NICE has already approved for this condition."

In March this year, NICE began a public consultation on proposed changes to the way it makes recommendations on new medicines and other treatments for use in the NHS.

The new proposals include ways to take into account more systematically and explicitly the severity of a disease, as well as the effect that diseases and conditions have on our capacity to engage in society.

Sir Andrew Dillon, Chief Executive of NICE, said: "These proposed changes to the way we value new treatments will add further clarity to our recommendations and enable our independent advisory committees to explore more fully the potential these treatments have to improve outcomes for patients."

The consultation ended in June, and the NICE Board will consider the final addendum to the ‘Guide to the methods of Technology Appraisals'. It is anticipated that changes will be introduced in the Autumn, and any topics appraised by NICE following approval of the final new methods will be subject to the new arrangements.

NICE publishes 300th technology appraisal

This year, we reached the milestone of publishing our 300th piece of technology appraisal guidance.

Our guidance recommended peginterferon alfa in combination with ribavirin to treat chronic hepatitis C in children with young people.

Hepatitis C, a blood-borne virus that infects the liver, chronically affects an estimated 200,000 people in England.

People who have injected drugs in the past, or who have been a regular sexual partner with someone with hepatitis C are more at risk than others of having the virus.

However, children of mothers with the disease are also at increased risk, with cases of children newly diagnosed with the virus emerging each year. Figures from the Health Protection Agency show that 26 babies aged under 1 were newly diagnosed with hepatitis C in England in 2011.

The independent appraisal Committee concluded that treatment with peginterferon alfa has long-term benefits that could potentially last for the lifetime of the child or young person, effectively providing a cure.

The committee also acknowledged that the treatment could provide benefits to parents and carers, such as reducing the guilt burden that is associated with transmission of hepatitis C from mother to baby.

Professor Carole Longson said: "The independent Appraisal Committee concluded that treatment with peginterferon alfa and ribavirin can decrease the hepatitis C virus to undetectable levels, effectively providing a cure for the disease.

"Early successful treatment is also likely to lessen the social stigma that can be associated with hepatitis C infection later in life."

She added: "By widening access to these drugs this guidance will give clinicians and people living with hepatitis C more treatment options."