Departing from the threshold

the treatment in question is life-saving (24)2. the illness is a result of NHS negligence (23)3. the intervention would prevent more harm in the future (23)4. the patients are children (22)5. the intervention will have a major impact on the patient's family (22)6. the illness under consideratio...

Full description

Corporate Authors: NICE Citizens Council, National Institute for Health and Clinical Excellence (Great Britain)
Format: eBook
Language:English
Published: London National Institute for Health and Clinical Excellence (NICE) 2008, 2008
Series:Citizens Council reports
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:the treatment in question is life-saving (24)2. the illness is a result of NHS negligence (23)3. the intervention would prevent more harm in the future (23)4. the patients are children (22)5. the intervention will have a major impact on the patient's family (22)6. the illness under consideration is extremely severe (21)7. the intervention will encourage more scientific and technical innovation (21)8. the illness is rare (20)9. there are no alternative therapies available (19)10. the intervention will have a major impact on society at large (16)11. the patients concerned are socially disadvantaged (13)12. the treatment is life extending (10)13. the condition being tackled is time-limited (9)14. the illness is a result of corporate negligence (2)15.
the stakeholders happen to be highly persuasive (0) It is clear from these votes that the great majority of us do not think that a view based solely on formulaic considerations of health economics is a satisfactory basis on which to make recommendations about the use of drug or other interventions by the NHS. Judgements also need to take account of other factors. Our conclusions offer support to the current NICE procedure - which, through the Social Value Judgment document, already recognises that appraisal committees cannot work by health economics alone. The continuing uncertainty is over which additional factors should be taken into account, and what weight they should carry. Not surprisingly - as the voting makes clear - within the Council there is a spectrum of opinion on these matters. But we hope that the pattern of our preferences may offer some guidance to appraisal committees as they do for real what we have done only in our imaginations
The Citizens Council provides NICE with a public perspective on overarching moral and ethical issues that NICE should take into account when producing guidance. Made up of members of the public, broadly representative of the adult UK population, the Council operates through a "citizens' jury" style meeting, to explore and respond to a question set by NICE. At its November 2008 meeting, the Citizens Council was asked: "In what circumstances should NICE recommend interventions where the cost per QALY is above the threshold range of £20-30,000?" Two of the 29 Council members attending the meeting took the view that there were no circumstances in which NICE appraisal committees should depart from the established threshold. The remaining 27 Council members considered a list of possible circumstances and for each one voted on whether it should be taken into account. The circumstances considered, with numbers of votes in favour shown in brackets, were: 1.
Physical Description:1 PDF file (35 pages)