Feature / NICE update

NICE guidance in February included:

Clinical guidelines

• CG138 Experiencing good NHS care. This is a concurrent clinical guideline and quality standard. It has not been possible to estimate national cost impact and local assessment of impact is encouraged. It is thought any additional investment in improvements to patient experience should result in savings from improved outcomes.

Technology guidance

• TA246 Venom anaphylaxis – immunotherapy pharmalgen. The use of pharmalgen for the treatment of bee and wasp venom allergy is estimated to cost just over £5,000 per patient, but the number of patients is expected to be small. About 200 patients start treatment each year, a cost offset by removing the need to carry adrenaline auto-injectors for life (estimated cost £1,058). It could also cut the cost of visits to emergency departments and any further treatment resulting from people not using their adrenaline auto-injector after being stung and presenting with anaphylaxis.
• TA247 Rheumatoid arthritis – tocilizumab (rapid review TA198). NICE has recommended the use of tocilizumab, taken with methotrexate, as a possible treatment for some people with rheumatoid arthritis. The guidance is unlikely to increase costs as it is a further treatment option for about 10,000 patients after other disease modifying drugs have failed. It should be noted that it is only recommended where the manufacturer provides the drug at the discount as part of a patient access scheme agreed with the Department of Health.
• TA248 Diabetes (type 2) – exenatide (prolonged release). NICE has recommended using prolonged release exenatide injections in combination with other drugs as a possible treatment for some people with type 2 diabetes. It is estimated about 40,000 people will be eligible for treatment with prolonged release exenatide. But it is unlikely to result in significant resource impact in the NHS as the cost compares with the cost of the alternative GLP-1 receptor agonists, also recommended by NICE.