NICE published the following guidance in June:
Clinical guidelines
CG141 Acute upper GI bleeding – Offers evidence-based advice on the effective management of upper gastrointestinal bleeding in adults and young people aged 16 years and older. No assessment is made of the national impact on resources, although it is likely implementation will generate savings.
CG142 Autistic spectrum conditions in adults – Because of the variation in current practice and insufficient data, it is not possible to quantify the national cost impact, but the report discusses the potential costs and savings that need to be considered locally.
CG143 Sickle cell acute painful episode – This report discusses the potential costs and savings that need to be considered at a local level and is supported by a local costing template.
CG144 Venous thromboembolic diseases – Offers evidence-based advice on the diagnosis and management of venous thromboembolic diseases, investigations for cancer in patients with venous thromboembolism and the role of thrombophilia testing. Recommendations on venous thromboembolism generally reflect current practice.
Technology appraisals
TA257 Breast cancer (metastatic hormonereceptor): lapatinib and trastuzumab (with aromatase inhibitor) – NICE does not recommend this technology. Therefore there is no cost impact.
TA258 Lung cancer (non small cell, EGFR-TK mutation positive): erlotinib (1st line) – This represents an additional treatment option for people with locally advanced or metastatic epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation-positive non-small-cell lung cancer. The cost of treatment with erlotinib will not be significantly different to the cost of the current standard treatment with gefitinib. The manufacturer of erlotinib has agreed a new patient access scheme with the Department of Health.
TA259 Prostate cancer (metastatic, castration resistant): abiraterone (following cytoxic therapy) – The annual cost associated with implementing this recommendation is estimated as £41m for the total population of England.
TA260 Migraine (chronic): botulinum toxin type A – The annual cost associated with implementing these recommendations at year five is estimated as £11.5m for the total population of England (assuming that 35% of the target population will have tried botulinum toxin type A by year five) . A number of assumptions are subject to uncertainty and where possible should be verified locally.
NICE update was prepared by Stephen Brookfield, (senior costing analyst) at NICE