Select Committee on Health Minutes of Evidence


ANNEX 2

MEASURING THE EFFECT OF NICE HEALTH TECHNOLOGY ASSESSMENTS (HTAS) ON MEDICINES CONSUMPTION

  Below are extracts of a summary of comparisons made by ABPI, using independent data from International Medical Statistics (IMS), between the predicted and actual effects of changes in prescribing following release of NICE guidance. The analysis is of those HTAs for which a year of market information is available following NICE guidance.

EXAMPLE 1—THE POSTCODE LOTTERY OF CARE PERSISTS—BREAST/OVARIAN CANCER

  Taxol—the variation in average quarterly consumption in units per female head of population in each English Health Authority for two quarters




EXAMPLE 2—NO DISCERNIBLE EFFECT ON PRESCRIBING FOLLOWING NICE GUIDANCE




EXAMPLE 3—EVIDENCE OF LOW UPTAKE VERSUS NICE PREDICTION

  Predicted v first year actual expenditure for medicines assessed by NICE to October 2000


  Breakdown of above analysis shown below.

Table

HTAs WHICH ANTICIPATE ADDITIONAL MEDICINES USAGE

  
NICE estimated additional cost
Actual additional cost for first year
Variance to predicted
Taxanes
+£23m
+£9m
-£14m
Hepatitis C
+£18m
+£4m
-£14m
ADHD
+£7m
+£0.25m
-£6.75m
GP IIb/IIIa inhibitors
+£29.5-31m
+£8m
-£21.5-23m
Total
+£77.5-79m
+£21.25m
-£56.25-57.75m


Table

HTAs WHICH ANTICIPATE SAVINGS DUE TO ADDITIONAL MEDICINES USAGE

  
NICE estimated additional cost
Actual additional cost for first year
Variance to predicted
Rosiglitazone
+£15.1m
+£10.5
-£4.6m


  Consumption calculation based on guidance for Pioglitazone and Rosiglitazone, NICE calculated savings for switch to both treatments £12 million per annum.

  Total estimated increased usage: £93-94 million.

  Actual increased usage: £32 million.

  Difference: underspend by £61-62 million.

Table

HTA WHERE DECREASED USAGE OF MEDICINES ANTICIPATED SAVINGS

  
NICE estimated saving
Actual saving (overspend)
Variance to predicted
PPIs
-£40m
+£34m
+£74m


  *Notes:

  ABPI data collection relates to the whole of the UK; NICE guidance covers England and Wales only. Consumption of pharmaceuticals in Scotland and N Ireland represents 14% of the UK.

  Analysis assumes that total additional consumption is attributable to the release of NICE guidance (an unrealistic assumption).

  Where a range of predicted expenditures was given, we have used the lower value quoted.



 
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Prepared 8 July 2002