A report entitled Use of NICE-appraised Medicines in the NHS in England – Experimental Statistics, published for the first time by the NHS Information Centre (NHSIC) looks at the uptake of selected drugs and treatments appraised by the National Institute for Health and Clinical Excellence (NICE).
A range of 26 drugs positively appraised by NICE were selected, covering 13 technology appraisals. Some are used mainly in primary care and others have a more specialised use in secondary care.
The report shows that out of the 12 appraisals where a comparison could be made, observed use by the NHS in England in 2008 was higher than predicted use for seven, and lower for five, and in one case (natalizumab for multiple sclerosis) observed use was lower than predicted use for 2008, but is rising and is likely to exceed the predicted level in 2009.
According to Tim Straughan, chief executive of the NHS Information Centre, the fact that observed use for the majority of treatments was greater than was predicted, along with the original guidance from NICE, will help the NHS to judge whether it is using its resources in line with NICE recommendations.
Andrew Dillon, chief executive of NICE responded to the findings by saying: “This new report shows that NICE guidance is having a significant impact on the treatment and care that patients receive from the NHS. It is also a recognition that NICE and its guidance is seen to represent value for money for the NHS.
As the NHS moves into a period of financial stringency it is being asked to focus on not just ensuring quality care but also on increasing productivity and innovation. It is therefore important that what NICE does, across the range of guidance that it produces, continues to reflect those priorities. It is equally important for local PCTs to ensure they are implementing NICE guidance appropriately and to help them do that NICE provides a range of tailored implementation support tools, including costing templates and slide sets, as well as a team of regional implementation consultants.”
The ABPI commented that while statistics showing the use of medicines approved by NICE is a welcome step forward, the basis on which the predictions were made appears to be too low and is in need of further development.
“Enthusiasm over the results is tempered by the knowledge that not only are there other medicines being prescribed less than predicted but also, even where uptake is generally good, there are still areas of the country where postcode prescribing is alive and well,” said Dr Richard Barker, director general of the ABPI. He added: “It is essential that the way of calculating the ‘predicted’ use of medicines is as robust as possible.”
The ABPI also believes that these statistics on the use of such medicines in England needs to be set against a comparison of uptake in other, comparable European countries.