James Raftery: NICE’s proposed new QALY modifier for appraising highly specialised technologies

After a consultation on changes to its methods for appraising health technologies, the National Institute for Health and Care Excellence (NICE) has gone public with its way forward. As discussed previously, the consultation sought views on four items: Introduce a “fast track” NICE technology appraisal process for the most promising new technologies, which fall below an incremental cost […]

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James Raftery: Changes to how NICE appraises drugs and other health technologies

The recent proposals by NICE and NHS England to change arrangements for evaluating and funding drugs and other health technologies not only tidy up the processes, but introduce some important new elements. The four proposed elements are to: Introduce a “fast track” NICE technology appraisal process for the most promising new technologies, which fall below an […]

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James Raftery on a short history of NICE

A terrible beauty: A short history of the National Institute for Health and Care Excellence by Nicholas Timmins, Michael Rawlins and John Appleby. Free download.   This story of NICE is a great read. The main author Nick Timmins, a former journalist for the Financial Times, now with the Kings Fund, tells a thriller like story […]

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James Raftery: Cancer drugs fund—consultation on bringing it under NICE

Conflict of interest: the proposals reviewed here are similar to those advocated in a 2014 BMJ editorial “Reforming the Cancer Drugs Fund” to which I was a co-author. I have had no involvement with the development of the proposed policy. The Cancer Drugs Fund continues to pose problems not least a rising spend, up from […]

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James Raftery: Ever higher cancer drug prices—driven by US policies and genetic sequencing

The high prices charged by companies for cancer drugs has led to lots of speculation, but very little explanation. The most interesting attempt to explain these high prices has been made by a US oncologist Scott Ramsey. As the article is paywalled, I summarise it below (with thanks to the author for a copy). His […]

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James Raftery: Cancer drug prices and olaparib

NICE’s provisional rejection of Astra Zeneca’s olaparib (Lynparza) for a genetic subset (BRCA1/2 gene mutation) of ovarian cancers has several themes which have not been commented on. One is that Astra Zeneca may have handled matters poorly. In particular it withdrew olaparib from consideration by the cancer drugs fund in December 2014. The reported reason […]

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James Raftery: NICE and value based pricing—is this the end?

Since Andrew Lansley announced in 2010 that the NHS would in future use “value based pricing” in its purchases of pharmaceuticals, civil servants and (more recently) the National Institute for Health and Care Excellence (NICE) have been struggling to develop an approach for how this could be implemented. For the twists and turns, see previous blogs on the […]

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James Raftery: NICE: “inconsistent,” “in large part arbitrary and opaque,” according to friends

A strong critique just published points to logical inconsistencies in NICE’s consideration of social values, specifically in how it handles quality adjusted life years (QALYs). Since these are key to many of the most controversial decisions made by NICE’s appraisal committees, this matters. It matters all the more that the authors include Tony Culyer, who […]

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James Raftery: Sofosbuvir for hepatitis C—moving to country specific prices

The National Institute for Health and Care Excellence (NICE) has provisionally approved sofosbuvir (brand name Sovaldi) for the treatment of hepatitis C, a decision that has surprised some commentators given its high price. The drug’s price in the United States of $84k for a 12 week course would be £54.6k at the current exchange rate of $/£0.65. But Gilead […]

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James Raftery: Should the NHS use the new meningitis B vaccine?

The argument over whether the NHS should fund Bexsero, the new meningitis B vaccine from Novartis, raises a global issue about the price of the new vaccine, as well as questions about the role of cost effectiveness analysis in setting prices for vaccines, and the processes of the Joint Committee on Vaccinations and Immunisation (JCVI), […]

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