NICE decision making

Question 1

How is NICE divided into centres?

Answer 1

Centre for technology appraisals
Centre for clinical practice and guidance
Centre for public health

Question 2

How is each centre divided?

Answer 2

Divided into boards for communication, health and social care, evidence, resource and business planning

Question 3

What does the technology appraisals programme do?

Answer 3

Make decisions regarding new therapeutic drugs, procedures and devices based on an explicit criteria and an independent assessor of the evidence provided by the company. Includes a cost effectiveness analysis against current practise, QALYs and equity weighting.

Question 4

What happens if a new intervention is more superior than the old?

Answer 4

Disinvestment in the old

Question 5

What is the process for technology appraisals?

Answer 5

Referral from department of health —> Submission —> Assessment —> Peer appraisal —> Preliminary recommendations —> Consultation on preliminary —> Final guidance —> Publication or appeal

Question 6

Why must an evidence review take place?

Answer 6

To see if the model proposed is reliable. Single technology appraisals do not have to wait for this.

Question 7

What must happen after appraisal?

Answer 7

Must receive funding within 3 months of the guidance being issues.

Question 8

What does approval mean?

Answer 8

The right to prescribe

Question 9

Who produces guidance?

Answer 9

Specialist group of clinicians and health economists

Question 10

What does the centre for public health deal with?

Answer 10

Public health issues. Multiple adviser committees made up of experts, community members and core members. Make choices on legislation, expenditure and infrastructure.

Question 11

Can QALYs be applied to public health?

Answer 11

Difficult due to other imposing factors such as education and transport.

Question 12

What 2 other national bodies are external to NICE?

Answer 12

Cancer drug fund

National screening committee

Question 13

What does the cancer drug fund do?

Answer 13

Receive faster appraisals and have a higher budget for funding. All therapies have a potential.

Question 14

What does the national screening committee do?

Answer 14

Decides whether or not to implement a programme based on the screening criteria?

Question 15

What is the screening criteria?

Answer 15

• A condition of high prevalence within a population that is fatal
• There is an available treatment
• Condition has a known and understood natural Hx
• There preclinical period where the condition is asymptomatic
• Suitable, non invasive test accessible for all
• Economically reasonable
• Criteria on who to treat