NICE and National Level Decision Making Flashcards
When was NICE established?
What was its original name?
Established in 1999 as National Institute for Clinical Excellence.
List the centres that compose NICE.
1 - Centre for health technology evaluation.
2 - Centre for clinical practice.
3 - Centre for public health.
List the directorates that are involved in the management of NICE.
1 - Communications.
2 - Health and social care.
3 - Evidence resources.
4 - Business, planning and resources.
List the appraisal committees that are run by NICE.
1 - Medical.
2 - Other clinical.
3 - Methodologists.
4 - Managers.
5 - Lay members.
6 - Manufacturers.
List 2 impacts of NICE decision making.
1 - Approved technologies must be funded within 3 months of positive guidance being issued.
2 - Approval means right to prescribe.
Describe the 2005-2010 case of NICE guidance on drug treatment for Alzheimer’s disease.
- 2005: Draft NICE guidance recommends no patients
should receive donepezil, galantamine or rivastigmine. - May 2006: Final guidance says those with moderate
Alzheimer’s are eligible, but those with mild Alzheimer’s are not. - October 2006: Internal NICE panel rejects appeals over
decision to exclude “mild” patients. - 2007: High Court backs NICE decision following
Judicial Review. - 2008: Court of appeal rules that NICE should make their economic model public, which calculates the financial benefits of a drug.
- 2009: NICE admits technical inaccuracies in the model, amends it, but does not alter guidance.
- 2010: A fresh review of the guidance backs prescribing all three drugs for mild Alzheimer’s disease, and includes a fourth for more advanced disease.
What do clinical guidelines involve?
Which group of people is responsible for issuing clinical guidance?
What are these groups composed of?
- Clinical guidance involves a broader coverage of a particular clinical area.
- The guideline development group of that area is responsible for the clinical guidelines.
- These groups mainly involve clinicians but also include health economists.
Which members compose the advisory committees for public health?
1 - Core members.
2 - Topic expert members.
3 - Community members.
What do all public health reports contain?
1 - An evidence review.
2 - A series of recommendations.
List 2 national level bodies that are not part of NICE.
1 - National screening committee.
2 - Cancer drug fund.
What is the purpose of the national screening committee?
To make decisions on whether to implement screening programmes, and if so, how.
List the 10 criteria for screening (Wilson and Jungner).
1 - The conditions should be an important health problem.
2 - An accepted treatment for patients with a recognised disease should be available.
3 - Facilities for diagnosis should be available.
4 - There should be a recognisable latent or early symptomatic stage.
5 - There should be a suitable test or examination.
6 - The test should be acceptable to the population.
7 - The natural progression of the condition should be adequately understood.
8 - There should be an agreed policy on whom to treat as patients.
9 - The cost of case-finding (diagnosis and treatment) should be economically sustainable.
10 - Case finding (diagnosis and treatment) should be a continuing process rather than a ‘once and for all’ project.
What is the need for the cancer drug fund?
- Cancer drugs are often very expensive.
- It was therefore established in order to provide a means by which patients could get cancer drugs that were rejected by NICE for not being cost effective.
