Feature / NICE update

NICE has published the following guidance over the past month

• CG140 Opioids in palliative care (CG140) Because of uncertainty over future practice it is not possible to quantify the national cost impact of implementing the guidance. Expert opinion suggests more patients are likely to start opioid treatment with morphine as opposed to more expensive opioids. Depending on patient response to morphine, there may be a need to change to other more expensive opioids.

• TA252 Hepatitis C (genotype 1) – telaprevir
• TA253 Hepatitis C (genotype 1) – boceprevir NICE recommends telaprevir or boceprevir with peginterferon alfa and ribavirin as a possible treatment for genotype 1 chronic hepatitis C in adults with the earlier stages of liver disease (known as compensated liver disease). This costing template looks at both technology appraisals for boceprevir and telaprevir for the treatment of chronic hepatitis C genotype 1 (NICE technology appraisal guidance 252 and 253 respectively). This is to facilitate easier assessment of the cost impact of the two new treatments being recommended as options for the same patient group. The cost impact at a national level is anticipated at £94m on a recurring basis for both technologies.
• TA 255 Prostate cancer – cabazitaxel. NICE does not recommend this technology. Therefore there is no cost impact.
• (TA256) Atrial fibrillation (stroke prevention) – rivaroxaban. NICE recommends rivaroxaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation. The cost impact is still being assessed and a costing template will be published shortly.

NICE update was prepared by Stephen Brookfield, (senior costing analyst) at NICE