Four technology appraisals for type 2 diabetes have been updated, and guidance on 4 further medicines is being withdrawn, as part of NICE's first test of a new way of keeping all its guidance aligned.
NICE recently updated its guideline on type 2 diabetes in adults. Several existing technology appraisals (TAs) for diabetes medicines had fallen out of step with the new recommendations.
To address this, NICE tested a new process as part of its whole lifecycle approach programme. A panel made up of the chair and vice chair of technology appraisal committee B, and the chair and vice chair of the guideline committee, was asked if it was appropriate to update the affected appraisals and align them with the guideline.
This allowed the TAs to be updated based on the evidence reviewed in the guideline, rather than requiring a new evidence submission for each appraisal. As a result, TA guidance on tirzepatide, ertugliflozin, empagliflozin and canagliflozin has been updated to bring it into line with the recommendations already made in NICE's guideline on type 2 diabetes in adults.
The recommendations for medicines under patent continue to be supported by a funding mandate. This supports adoption and uptake of the recommendations.
Separately, 4 appraisals covering specific uses of dapagliflozin and other SGLT-2 inhibitors are being withdrawn. NICE does not consider it appropriate to routinely update TAs for medicines that are no longer under patent, such as dapagliflozin, and use of dapagliflozin is now covered by class-level recommendation of SGLT-2 inhibitors in the guideline. The guideline recommends use of the least expensive suitable SGLT-2 inhibitor, considering administration costs, dosages, price per dose and commercial arrangements.
The withdrawal of the TAs for dapagliflozin is not expected to impact patient and clinician choice. As dapagliflozin is now off-patent, it is likely to be the least expensive option in many cases, but the guideline does not name a single preferred medicine.
Diabetes is an important area of work for NICE. As well as recently updating its recommendations on medicines for adults with type 2 diabetes, NICE has published guidance covering type 1 and type 2 diabetes in adults, the diagnosis and management of diabetes in children and young people, the prevention and management of diabetic foot problems, the management and monitoring of diabetic retinopathy, and diabetes in pregnancy.
The government's 10 Year Health Plan for England sets out how NICE will take a whole lifecycle approach to updating guidance to drive smarter spending in the NHS. This broad programme of work includes bringing our different types of guidance together so that users can easily find the recommendations they need and so that inconsistencies between different guidance on the same topic are reduced.
The updated recommendations are being issued in draft guidance for consultation and remain subject to the standard NICE appeals process for:
- tirzepatide
Excerpt from the official page. The original is authoritative. Continue reading at UK NICE ↗