The National Institute for Health and Clinical Excellence (NICE) technology appraisal process assesses the clinical and cost effectiveness of new and existing drugs and treatments, and provides guidance on their use by the NHS. As part of the Pharmaceutical Price Regulation Scheme (PPRS) agreement which came into operation on 1 January 2009, the Department of Health (DH) and the Association of the British Pharmaceutical Industry agreed that the DH would review the variation in uptake of selected medicines in the NHS in England.
The NHS Information Centre was asked to produce a bulletin looking at variation in the use of these medicines in relation to the number of eligible patients as estimated by NICE. Data on the number of patients being treated is not available and so predicted use (using the average dose and average length of treatment) was compared with observed use. Data on observed use in 2010 and 2011 was taken from the primary care prescribing data from NHS Prescribing Services and secondary care data provided by IMS Health. Several pharmaceutical companies also provided their own data.
In all 52 medicines in 25 groups, relating to 35 technology appraisals, were considered. For 13 groups a comparison could be made (these are presented in Section 1 of the technology section results). For those appraisals where a valid comparison could not be made (these are presented in Section 2 of the technology results), the reasons why the comparison could not be made are presented along with a series of questions inviting the reader to suggest improvements to the method or data. A third section presents an approach to analysing the use of biologics medicines for the treatment of rheumatoid arthritis on which we welcome comments.
The report was amended on 11 December 2012 to include NICE guidance on the use of denosumab for secondary prevention of fractures in osteoporosis (page 53). There are no other changes to the text or figures.
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This is an experimental publication and is the third of a planned annual series. We invite feedback to help inform how best to estimate uptake to allow meaningful interpretation of any variation across NHS organisations in future.
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