NICE update: Dialysis patients given greater choice

In October, NICE recommended four new technologies for use in the NHS, as well publishing guidelines on renal replacement therapy and decision-making and mental capacity, writes Gary Shield.

Recommendations in the guideline on renal replacement therapy mean people being treated with dialysis after kidney failure are to be offered a choice over where and what type of treatment they have. Patients, in discussion with their clinician, should choose the type of dialysis that is right for them and where they can have their treatment.

Three types of dialysis are offered on the NHS depending on local arrangements and suitability for the patient. Once a decision is taken, the patient, in consultation with their clinician, will decide whether treatment takes place at home or in hospital. This will also depend on local arrangements.

The independent NICE committee agreed clinicians should consider offering haemodiafiltration (HDF) in the first instance to patients who opt for treatment in hospital. This may lead to a rise in the number of patients using HDF rather than haemodialysis (HD). The associated resource impact tools model various scenarios to look at the potential costs of implementing the guideline.

On the technologies front, TA542 Cabozantinib for untreated advanced renal cell carcinoma recommends cabozantinib for adults with untreated advanced renal cell carcinoma that is intermediate or poor risk, as defined in the International Metastatic Renal Cell Carcinoma Database Consortium criteria.

TA544 Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma recommends dabrafenib with trametinib as an option for adults with this type of cancer.

More than 1,700 and 600 people respectively are estimated to be eligible for each of these technologies.

Gary Shield is resource impact assessment manager at NICE