On 2 January 2009 the National Institute for Health and Clinical Excellence (NICE) issued guidelines intended to improve access to drugs which may extend life for small numbers of terminally ill patients not expected to live more than two years. Such drugs would normally fail NICE’s cost-effectiveness test or, indeed, never come under NICE’s scrutiny in being too expensive to be submitted for appraisal in the first place.

The guidelines, effective from 5 January 2009, take the form of a supplementary advice forming an addendum to section 6.2.25 of NICE’s Guide to the Methods of Technology Appraisal. The advice will apply to treatments which have an Incremental Cost Effectiveness Ratio (ICER) in excess of £30,000 (the ICER being the deemed approximate cost of a year of reasonable quality life for the patient) and which may offer demonstrable survival benefits over current NHS practice.

Although perceived as the gateway to precious extra months of life, enabling some patients, perhaps, to live long enough to witness a significant event, such as the birth of a grandchild, the guidelines will only apply to treatments for, in effect, the less common cancers. The Chairman of NICE, Professor Sir Michael Rawlins, suggested that it was for the pharmaceutical industry to take the initiative to lower drugs costs for more common conditions.

The guidelines can be accessed here.