NICE's position on key topics
Statins
Our guidance on the risk assessment and reduction of heart disease and strokes, including lipid modification, is based on the overwhelming body of evidence supporting the use of statins, even in people at relatively low risk.
The NICE guideline does not impose statins on everyone with a 10% or greater risk of developing heart disease or having a stroke within 10 years; it recognises the importance of personal choice in determining what measures are appropriate for preventing these. Our guidance says that due to a drop in the price of statins, these drugs are now cost effective at a lower clinical threshold. Decisions about whether patients should start or continue statin treatment should be made by the patient with their doctor.
The effectiveness of statins is now well proven, as is their long term safety, and they are relatively cheap. To make progress in the battle against heart disease and stroke we must encourage exercise, improve our diets still further, stop smoking, and where appropriate offer statins to people at risk.
Menopause
Most women experience some symptoms with menopause. The depletion of oestrogen associated with menopause causes irregular periods and has many other effects on the body.
Symptoms include hot flushes and night sweats, mood changes, memory and concentration loss, vaginal dryness, a lack of interest in sex, headaches, and joint and muscle stiffness. Quality of life can also be severely affected.
The NICE guideline addresses the diagnosis and management of menopause. It covers women in perimenopause and postmenopause, and the particular needs of women with premature ovarian insufficiency and women with hormone-sensitive cancer (for example, breast cancer). This guideline is currently being updated. The areas of evidence being looked at are set out in the scope. These include cognitive behavioural therapy to manage symptoms associated with menopause, interventions to manage genitourinary symptoms and the effects of hormone replacement therapy on overall health outcomes.
All updates for this are published on the menopause guideline update webpage.
Cancer Drugs Fund (CDF)
Our approach to assessing the value of new cancer drugs has been reviewed on a regular basis since we were set up in 1999. The changes we made in response to the CDF reforms will help deliver faster access to effective cancer treatments.
For the first time, we are able to give patients access to a promising new cancer treatment whilst more evidence is gathered on its effectiveness. Where the case for routine use is not clear cut and more evidence is needed to prove cost effectiveness then NICE can now recommend a drug for temporary, conditional use in the new CDF.
The new process can work well where companies work with NICE to price their drug affordably and present a clear case for additional evidence to be gathered if they are to be included in the CDF. It is now up to companies to show that they recognise the challenges as well as the opportunities their new drugs present to the NHS.
Frequently asked questions
About NICE and our guidance
When was NICE formed?
The National Institute for Clinical Excellence was set up in 1999. It then merged with the Health Development Agency in 2005 and changed its name to the National Institute for Health and Clinical Excellence.
How do you choose what to produce guidance on?
Guidance topics are referred to us by NHS England and the Department of Health and Social Care.
Who produces your guidance?
NICE guidance is developed by independent committees of experts. It may be a standing committee working on many guideline topics, or a topic-specific committee put together to work on a specific guideline.
Each of our guidance programmes has its own process for developing guidance. Find out more about our guidance programmes here
How do you check they are the best people to produce the guidance?
All NICE committees include topic experts and lay-members who may have personal experience or know someone who has (such as a parent of a sick child).
Where is your guidance applicable?
NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive.
Do healthcare professionals have to follow your guidance?
NICE technology appraisal decisions are the only legally-binding, mandatory recommendations NICE produces. These apply to drugs available on the NHS. The rest of the guidance NICE publishes aims to support decisions made by staff working in the health and social care sector. It is not mandatory.
How do you decide if your guidance needs updating and how often do you check it?
All NICE guidance is regularly checked, and updated in light of new evidence if necessary.
About our guidance on drugs
Do you recommend which drugs should be used as treatment?
NICE technology appraisals provide the NHS with evidence-based guidance on the clinical and cost effectiveness of drugs and treatments in order to ensure the most efficient use of NHS resources.
How do you decide whether a drug should be available on the NHS?
NICE technology appraisals guidance assesses the clinical and cost effectiveness of the drugs referred to NICE by the Department of Health and Social Care and NHS England. NICE makes decisions based upon evidence, cost effectiveness and contributions from patient organisations, health professionals, experts, and other interested parties.
Read more about the decisions we make through our technology appraisal programme
Do you usually recommend drugs or are they always too expensive?
The cost of the drug being appraised is just one thing the NICE committee considers. Costs will always be assessed alongside how effective the treatment is.
In some instances the drug company provides a patient access scheme so that the price of the drug falls into the boundaries of NICE recommendations.
See the latest statistics on the number of drugs we have approved
How soon after you’ve recommended a drug is it available to patients?
The NHS should make the drug available within 3 months of the NICE guidance being issued unless there is an alternative market access agreement from NHS England.
How many drugs do you appraise every year?
All NICE guidance is regularly checked, and updated in light of new evidence if necessary.
From 1 March 2000 to 30 June 2016, NICE published 239 single technology and 173 multiple technology appraisals ; 412 appraisals in total, containing 679 individual recommendations. That works out to be just over one hundred every year.
What is the Cancer Drugs Fund - are you in charge of that too?
The Cancer Drugs Fund (CDF) was set up by the Government in 2011 for people in England to access cancer drugs that were not routinely available on the NHS. NICE began to reappraise all drugs currently in the CDF in July 2016
Contact the press office
Office hours: Mon to Fri, 9:00am to 5:30pm
07973 970 534
This number is for journalists only. Members of the public should send a message to our enquiry handling team at nice@nice.org.uk.
James Baker media relations manager
Matthew Brown media relations manager
Phil Ranson media relations manager
Michelle Wallington media relations manager
Georgina Fletcher media relations executive.