Feature / NICE update

Guidance released in July and August included:

Clinical guidelines
• CG145 Spasticity in children and young people – It is not possible to quantify the national cost impact but this report discusses the potential changes to current practice and costs and savings that need to be considered locally.
• CG146 Osteoporosis fragility fracture – This covers the selection and use of risk assessment tools in the care of people who may be at risk of fragility fractures in all settings giving NHS care. Although no national resource impact is calculated, a costing template will help local assessments.
• CG147 Lower limb peripheral arterial disease – This report discusses the potential costs and savings that need to be considered at a local level.
• CG148 Urinary incontinence in neurological disease – The annual change in resource use from the recommendations is put at £1.1m for England
• CG149 Antibiotics for early-onset neonatal infection – The annual impact of implementing the recommendations in England is a £49.8m saving.
  Technology appraisals
• TA261 Venous thromboembolism (treatment and long-term secondary prevention) – rivaroxaban – A saving of £1.9m is estimated in the first year and £1m thereafter for the total population of England.
• TA262 Ulcerative colitis (moderate to severe, second line) – adalimumab – This is a terminated technology, so no cost impact.
• TA263 Bevacizumab with capecitabine for the first-line treatment of metastatic breast cancer – NICE does not recommend this technology.
  Public health guidance
• PH38 Preventing type 2 diabetes – The costs associated with this guidance over five years are estimated to be £170m in total or an average of £34m a year for the next five years.
  Medical technology guidance
• MTG11 Mega soft patient return electrode for use during monopolar electrosurgery – The benefits and cost impact are dependent on individual operating theatre practices and organisations are urged to examine local practice when considering adoption.
  Diagnostics technology guidance
• DG4 Adjunctive colposcopy technologies for examination of the uterine cervix – DySIS and the Niris imaging system (DG4) – Annual savings of £4.1m across England need to be seen against a non-recurring cost to buy equipment, put at £2.1m.
• DG5 SonoVue (sulphur hexafluoride microbubbles) – contrast agent for contrastenhanced ultrasound imaging of the liver (DG5) – Annual saving estimated as £2.7m across England.