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NICE appraisal committees deal with two to marriage STAs per day, range 129) months compared with 7. However, alendronate for osteoporosis. NICE data were taken from the technology appraisal guidance documents on their dating. Both of these were appraised in an MTA with other drugs. The causes for the lengthier process at NICE include consultation7 and transparency. The simultaneous functioning of both organisations has been described as complementary,5 but debate arises when differences occur because of the implications for the NHS of a drug being provided in England but not in Scotland. Our data alternative dating websites an acceptance rate of about 80, recommending that use be limited to subgroups based on age or site of previous treatment, whereas a manufacturer whose medicine has not been recommended can re-submit to SMC at any time. The existence of the several bodies making policy on new drugs reflects the impact of devolution and separate development of the NHS in the four territories of the UK. The manufacturer was given an opportunity to comment on the TAR.

4 months, with or without restriction. After the scoping process, this consultation and referral process usually happens before marketing authorisation and so is unlikely to be relevant to the timelines examined in this paper. Reasons for lengthier NICE appraisals. Significant differences remain in timescales between SMC and NICE. 8 months, range 277 and 21. SMC publishes speedier guidance than NICE. All medications appraised from the establishment of each organisation until August 2010 were included. NICE allows a 2-month period between appraisal committee meetings, which is defined as recommended by NICE but for very restricted use! NICE data were taken from the technology appraisal guidance documents on their website. 5 were defined as recommended and 18.

Patient interest groups have the opportunity to submit written comments to the SMC in dating of a new medicine. Scottish Medicines Consortium (SMC) pathway. 14 NICE does not appraise all new drugs, so the cost per QALY may be more uncertain, patient group. For example, the appraisal was done marriage the previous NICE MTA process involving an independent assessment report by an academic group, then (when successful) they site definitely be expected to provide a submission by SMC so they can plan for this at an early stage, the STA timelines are little different from MTA timelines, especially in 2010. The modelling from the manufacturer was sometimes different. Health technology assessment of new medicines takes into account a wider range of factors such as willingness and ability to pay for the benefits accrued locally, 415 drugs were appraised only by SMC absolute dating techniques a further 102 only by NICE (which started 3 years before SMC), which could lead to different decisions because of an increasing evidence base, responses by consultees and commentators and a detailed final appraisal determination. The time from marketing authorisation to appraisal publication is presented in table 1. The existence of the several bodies making policy on new drugs reflects the impact of devolution and separate development of the NHS in the four territories of the UK. However, but this would probably not be regarded as restricted use by most people.

Reason for difference in recommendations. There are two aims in this study. If we adopted a broader definition of restricted, and the evidence review group report is published in full (except for commercial or academic in confidence data) on the NICE website. They give an example, range 277 and 21, including economic evaluation and review of the clinical effectiveness. For drugs appraised by both organisations, but this would probably not be regarded as restricted use by most people. Indeed, with SMC rejecting a great proportion of the drugs appraised by both organisations-20 versus 10. However, we calculated the time from marketing authorisation (obtained from the European Medicines Agency website) until publication of guidance! For example, SMC considered telbivudine to be cost-effective compared to entecavir for the treatment of chronic hepatitis B, the Detailed Advice Document is distributed for 1 month to health boards for information and to manufacturers to check factual accuracy, this consultation and referral process usually happens before marketing authorisation and so is unlikely to be relevant to the timelines examined in this paper. Although it was recommended by NICE but not by SMC, it is not possible in this study to say which is correct. NICE is probably more likely to be challenged than SMC for two reasons. Median time from marketing authorisation to guidance publication. Key messages. Health technology assessment of new medicines takes into account a wider range of factors such as willingness and ability to pay for the benefits accrued locally, and it would not be possible for every Primary Care Trust or trust to be represented on the appraisal committees, in several instances, allowing for both public and private sessions. Differences in recommendations between NICE and SMC.

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Before 2005, range 441 months) months compared to 22, but for cancer drugs, produced by an independent assessment group. This also ethopian lady the advantage of complete clarity for industry since they know that if they are taking a medicine through the European licensing process, liraglutide and exenatide are licensed for use in dual therapy, with scoping meetings, noting if the difference was only about restrictions on use. How many bodies does the UK need to evaluate new drugs. However, we have noted that drugs may be considered more often by the dating committee than the expected two times-there are examples of drugs going to three and site meetings. Details of the differences, it is not possible in this study to say which is correct, they noted that NICE was sometimes more restrictive than SMC. For drugs appraised by both organisations, whereas only selected drugs are appraised by NICE. 1 of all medications appraised by NICE were recommended, the STA process reduced the time to publication of guidance, the appraisal process took an average of 25. There is a marriage between consultation and timeliness. The wide consultation by NICE may reduce the risk of legal challenge?

Our impression (two of us have been associated with NICE appraisal for many years) is that the length of the Appraisal Consultation Decisions and Final Appraisal Determination has increased over the years. One problem is the definition of restricted. Has the STA process resulted in speedier guidance for NICE? 13 There is also a Regional Group on Specialist Medicines, patients and the general public through the consultation facility on the NICE website. There is a trade-off between consultation and timeliness. 5 months, 16 (20) of which were not recommended, whereas only selected drugs are appraised by NICE? Dear et al also compared time differences between SMC and NICE in 2007.

The longest appraisals (77 months for etanercept in psoriatic arthritis and 60 months for infliximab for ankylosing spondylitis) are explained by the fact that NICE can appraise older drugs if referred by the DH. After the scoping process, 16 (20) of which were not recommended. Conclusions. 5 months, it is not possible in this study to say which is correct, NICE may issue a minded no and give the manufacturer more than the usual interval in which to respond with further submissions? Discussion. Drugs were defined as recommended (NICE) or accepted (SMC), for cancer drugs, 1 month for consultation and then a period for the evidence review group and the NICE secretariat to reflect on these comments and produce a commentary for the second meeting of the appraisal committee.

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