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Spending on pharmaceuticals within the National Health Service could increase as a result of the work of the National Institute for Clinical Excellence, according to the Secretary of State for Health (Mr Alan Milburn).
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Alan Milburn: NICE creates financial headroom for new drugs |
"That is how patients will get the drugs they need, while being protected from those they do not. So, rather than just adding new treatments at the margin, the NICE will actively displace those older treatments which can now be superseded."
Mr Milburn said that the Government was increasing the amount spent on the NHS by an average of 4.5 per cent per year in real terms over the next three years, adding: "And the pharmaceutical growth element of this is even greater."
"I see no reason why in future new drug treatments should not comprise a much higher share of the growing NHS budget - which is precisely why we have taken the arbitrary cap off drug spending by developing unified budgets."
Mr Milburn also announced the timetable for the first programme of appraisal work to be undertaken by the NICE, which was published as part of the institute's business plan for 1999-2000. The first guidance notes for the NHS are expected to be published in March, 2000, and will cover prostheses for hip replacement and the routine extraction of wisdom teeth. The first guidance on pharmaceutical products will be in April, 2000, (assuming that no appeal is made by manufacturers) and will cover taxanes in breast and ovarian cancer.
Appendix A of the business plan outlines 23 areas to be covered by the NICE, with publication dates through to February, 2001 (see Table 1). Full details are available on the NICE website (www.nice.org.uk).
Table 1: First appraisal work programme for the NICE |
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| Treatment area | Final appraisal date | Guidance published* |
| Hip prostheses for hip replacement | February 22, 2000 | March, 2000 |
| Routine extraction of wisdom teeth | February 22, 2000 | March, 2000 |
| Taxanes for breast and ovarian cancer | March 29, 2000 | April, 2000 |
| Coronary artery stents | March 29, 2000 | April, 2000 |
| Liquid based cytology in cervical screening | April 27, 2000 | May, 2000 |
| Inhaler systems for childhood asthma | March 30, 2000 | June, 2000 |
| Proton pump inhibitors for dyspepsia | May 30, 2000 | June, 2000 |
| Hearing aids | June 28, 2000 | July, 2000 |
| Beta-interferon and glatiramer for multiple sclerosis | July 27, 2000 | August, 2000 |
| Rosiglitazone for type II diabetes | July 27, 2000 | August, 2000 |
| Zanamivir and oseltamivir for influenza | August 22, 2000 | September, 2000 |
| Implantable cardioverter defibrillators | August 22, 2000 | September, 2000 |
| Glycoprotein IIb/IIIa for unstable angina | August 22, 2000 | September, 2000 |
| Ribavarin and alpha-interferon for hepatitis C | September 27, 2000 | October, 2000 |
| Methylphenidate for childhood hyperactivity | September 27, 2000 | October, 2000 |
| Laparoscopic surgery | October 26, 2000 | November, 2000 |
| Autologous cartilage transplantation | October 26, 2000 | November, 2000 |
| Donepezil, rivastigmine and galantamine for Alzheimer's disease | November 28, 2000 | December, 2000 |
| Riluzole for motor neurone disease | November 28, 2000 | December, 2000 |
| Cox-2 inhibitors | December 13, 2000 | January, 2001 |
| Wound care** | December 13, 2000 | January, 2001 |
| Pioglitazone for type II diabetes | January, 2001 | February, 2001 |
| Orlistat and sibutramine for obesity | January, 2001 | February, 2001 |
| Notes: *The exact date of issue for guidance depends on whether or not an appeal is made. **Exact topic to be defined later | ||
It has also been revealed that the NICE has been instructed to take account of the fact that pharmaceutical companies may not have made obtaining cost effectiveness data part of their clinical trials programmes in the past when undertaking the first assessments of products.
Quoted in the Financial Times on December 10, Mr Andrew Dillon (chief executive, NICE) said the NICE would be looking for such data in future and would be issuing further guidance in the new year.