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Decision-making in NICE single technological appraisals (STAs): How does NICE incorporate patient perspectives?

Hashem, Ferhana, Calnan, Michael W., Brown, Patrick R. (2017) Decision-making in NICE single technological appraisals (STAs): How does NICE incorporate patient perspectives? Health Expectations, 21 (1). pp. 128-137. ISSN 1369-6513. E-ISSN 1369-7625. (doi:10.1111/hex.12594) (KAR id:62038)

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Context: The National Institute for Health and Care Excellence (NICE) has an explicit mandate to include Patient and Public Involvement (PPI) in the appraisal of medicines to be available for funding on the NHS. NICE involves an appraisal committee who are required to take on board experiential evidence from patient experts alongside population-based evidence on clinical and cost-effectiveness when making a decision whether to fund a drug.

Objective: This paper considers how NICE Single Technological Appraisal (STA) committees attempt to incorporate the views of patients in making decisions about funding medicines on the NHS.

Methods: A prospective design was employed to follow three pharmaceutical products involving three different appraisal committees. Three data collection methods were used: analysis of documentary evidence sent by NICE, non-participant unstructured observations of the open and closed sessions of meetings and qualitative interviews.

Setting & Participants: Unstructured non-participant observations were carried out at nine STA meetings and 41 semi-structured interviews were undertaken with committee members from NICE’s STA committees, patient experts, analysts from NICE’s project team and drug manufacturers.

Results: Our analysis showed how the committees displayed a preference for an ideal-type of patient representative, disagreement amongst the committee when weighing-up patient statements in the STA process, and more pre-preparation support for patient involvement.

Conclusions: Although NICE has attempted to adopt an approach flexible to patients and carers through formal decision-making arrangements that incorporate patient views, nonetheless, the processes of the STAs can in fact undermine the very evidence collected from patient representatives.

Item Type: Article
DOI/Identification number: 10.1111/hex.12594
Uncontrolled keywords: decision‐making; drug appraisals; NICE; patient experts; rationing; written and oral evidence
Subjects: H Social Sciences
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Michael Calnan
Date Deposited: 12 Jun 2017 10:19 UTC
Last Modified: 29 Oct 2021 14:37 UTC
Resource URI: (The current URI for this page, for reference purposes)
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