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Effects of the National Institute for Health and Clinical Excellence's technology appraisals on prescribing and net ingredient costs of drugs in the National Health Service in England

Published online by Cambridge University Press:  21 July 2009

Eva Susanne Dietrich
Eva Susanne Dietrich*
Affiliation:
TK Scientific Institute for Benefit and Efficiency
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Abstract

Objectives: The aim of this study was to examine the impact of the National Institute for Health and Clinical Excellence's (NICE's) negative and restricting technology appraisals on the number of prescription items dispensed and the corresponding total net ingredient costs for drugs from 2000 to 2004 in the ambulatory care of the National Health Service (NHS) in England and Wales. In addition, it is discussed whether the NICE approach could be a role model for Germany.

Methods: The number of prescription items dispensed and the net ingredient costs of thirty-one drugs reimbursed by the NHS were analyzed, thereof thirteen drugs descriptively and twenty-one drugs with regression analyses. Data were extracted from the “Prescription-Costs-Analysis-Statistics” for the ambulatory care of the British Department of Health (England 1993–2005). In the case of the twenty-one drugs analyzed by regression analyses, predictions were established how the prescribing and the costs would have developed without NICE's drug appraisal. Finally, conclusions were drawn whether NICE's negative and restricting drug appraisals had a decreasing effect or not.

Results: For 97 percent of the drugs analyzed in this study, the publication of NICE's fourteen negative and restricting technology appraisals of drugs between 2000 and 2004 did not reduce the number of prescription items dispensed and net ingredient costs in the ambulatory care of the NHS in England and Wales.

Conclusions: Cost-effectiveness appraisals as performed by NICE or the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) are a useful and important tool to enhance the discussion about methods and acceptance of evidence-based medicine in general.

Keywords

NICETechnology appraisalsHealth technology assessmentIQWiGTechniker Krankenkasse
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 262 - 271
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1. Abacus International; Howard S, Harrison L. NICE Guidance Implementation Tracking. Data Sources, Methodology & Results. 2005. http://www.nice.org.uk/niceMedia/pdf/Abacus_report.pdf (accessed November 2, 2008).Google Scholar
2. Audit Commission. Managing the financial implications of NICE guidance. http://www.audit-commission.gov.uk/SiteCollectionDocuments/AuditCommissionReports/NationalStudies/ManagingTheFinancialImplicationsOfNiceGuidance08Sep05REP.pdf.Google Scholar
3. Bundesministerium für Gesundheit (German Department of Health). Gesetz zur Stärkung des Wettbewerbs in der Gesetzlichen Krankenversicherung (GKV-Wettbewerbsstärkungsgesetz-GKV-WSG), Page 6–7, http://www.bmg.bund.de/cln_041/nn_600124/DE/Gesetze-und-Verordnungen/zur-Gesetzlichen-Krankenversicherung/zur-gesetzlichen-krankenversicherung-node,param=.html__nnn=true (accessed 07 May 2007).Google Scholar
4. Department of Health. New statutory obligations for NHS to fund treatments recommended by NICE. Press release 2001/0599. http://www.dh.gov.uk/en/Publicationsandstatistics/Pressreleases/DH_4011543 (accessed November 22, 2006).Google Scholar
5. Department of Health. Prescription costs analysis statistics. http://www.dh.gov.uk/PublicationsAndStatistics/Statistics/StatisticalWorkAreas/StatisticalHealthCare/fs/en (accessed May 7, 2007).Google Scholar
6. Duerden, M, Miller, J, Godmann, B, Mallinson, M, Sullivan, N. Centralized guidance - how NICE and SIGN impact on care in the UK. In: Klusen, N, Straub, Ch, eds. Bausteine für ein neues Gesundheitswesen - Technik, Ethik, Ökonomie; 2003:51–61.Google Scholar
7. IGES Institut für Gesundheits- und Sozialforschung; Cassel D, Wille, E. Steuerung der Arzneimittelausgaben und Stärkung des Forschungsstandortes für die pharmazeutische Industrie. Gutachten für das Bundesministerium für Gesundheit. Berlin: Bundesministerium für Gesundheit, Referat Öffentlichkeitsarbeit; 2006.Google Scholar
8. NICE, National Institute for Health and Clinical Excellence. Home page. http://www.nice.org.uk (accessed November 2, 2008).Google Scholar
9. NICE, National Institute for Health and Clinical Excellence. NICE Annual Reports 2000–2005. http://www.nice.org.uk/page.aspx?o=201896 (accessed May 7, 2007).Google Scholar
10. NICE, National Institute for Health and Clinical Excellence. Published technology appraisals. http://www.nice.org.uk/guidance/index.jsp?d-16544-s=2&d-16544-o=2&status=3&d-16544-p=9&action=byType&type=6 (accessed November 28, 2008).Google Scholar
11. NICE, National Institute for Health and Clinical Excellence. NICE Annual Report 2005–2006. Available from: http://www.nice.org.uk/niceMedia/pdf/boardmeeting/brdju106item2.pdf (accessed June 4, 2009).Google Scholar
12. Office of Fair Trading. The Pharmaceutical Price Regulation Scheme - An OFT market study. http://www.oft.gov.uk/shared_oft/reports/comp_policy/oft885.pdf (accessed December 18, 2008).Google Scholar
13. Raftery, J. NICE: Faster access to modern treatments? Analysis of guidance on health technologies. BMJ. 2001;323:1300–1303.CrossRefGoogle ScholarPubMed
14. Raftery, J. Review of NICE's recommendations, 1999–2005. BMJ. 2006;332:1266–1271.CrossRefGoogle ScholarPubMed
15. Rawlins, MD. In pursuit of quality: The National Institute for Clinical Excellence. Lancet. 1999;353:1079–1082.CrossRefGoogle ScholarPubMed
16. Rawlins, MD. NICE and the public health. Br J Clin Pharmacol. 2004;58:575–580.CrossRefGoogle ScholarPubMed
17. Rothgang, H, Niebuhr, D, Wasem, J, Greß, S. Das National Institute for Clinical Excellence (NICE) - Staatsmedizinisches Rationierungsinstrument oder Vorbild für die evidenzbasierte Bewertung medizinischer Leistungen? Gesundheitswesen. 2004;66:303–310.Google Scholar
18. Sheldon, TA, Cullum, N, Dawson, D, et al. What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews. BMJ. 2004;329:999–1003.CrossRefGoogle ScholarPubMed
19. Scriba, P C, Middeke, M. Was das IQWiG besser machen (können) sollte. Dtsch Med Wochenschr. 2007;137:137–138.CrossRefGoogle Scholar
20. Waiß, S. Das National Institute for Clinical Excellence. Lösungsansätze für die Qualitäts- und Effizienzdefizite im deutschen Gesundheitswesen? Sozialer Fortschritt. 2003;47–54.Google Scholar
21. Zentner, A, Valesco-Garrido, M, Busse, R. Methoden zur vergleichenden Bewertung pharmazeutischer Produkte. Eine internationale Bestandsaufnahme zur Arzneimittelevaluation. DIMDI (eds.); 2005. http://gripsdb.dimdi.de/de/hta/hta_berichte/hta122_bericht_de.pdf (accessed November 2, 2008).Google Scholar