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[IPk] NICE & pumps

Hi All,

I thought you would be interested in the latest Press Release from NICE. I
would also welcome your comments please.

John Davis,

New drugs for colorectal cancer, breast cancer and epilepsy and treatments
for diabetes and kidney patients are being referred to the National
Institute for Clinical Excellence (NICE), Health Minister Lord Philip Hunt
confirmed today.

The treatments are part of a sixth wave of topics which are being looked at
by NICE following consultation.

NICE will also produce and update guidelines to help spread best practice
and equal access to care throughout the health service. This will include a
clinical guideline to identify genetic risk of developing breast cancer.
There will also be an appraisal of the use of home dialysis

Guidance on the use of catheters for the intravenous feeding of sick newborn
babies will also be produced by NICE. This guidance was one of the
recommendations from a review into the practice following the death of four
babies in the Greater Manchester area last year whilst receiving treatment
in this way.

Lord Hunt said:

"NICE was set up to help ensure that patients have equal access to
clinically and cost effective treatments wherever they live and that the
health service has clear evidence-based guidance on the most up-to-date ways
of treating patients. This sixth work programme is another step in our
determination to ensure that both these goals are achieved.

"I am particularly pleased that, while it covers key Government priorities
such as cancer and heart disease, it also takes in a wider agenda - for
example looking at the benefits that may be brought to kidney patients by
having their dialysis at home, instead of hospital.

"The inclusion of guidance on the intravenous feeding of sick newborn babies
will also help produce a swift response to the recent report into the tragic
cases in Manchester."

NICE was set up in 1999 to help tackle the postcode lottery of prescribing -
where treatments are available in some areas and not others. It should also
speed up the uptake of clinically and cost effective new treatments by
issuing clear, evidence-based guidance to the NHS on the use of drugs and

Notes to editors

The NICE sixth work programme covers:

Drugs and treatments:

4 Patient education models for diabetes

Increasingly patients with diabetes are being encouraged to take control of
their own condition. A number of specific models of patient education have
been developed, one of which is being trialed in the UK. If further results
confirm the promising interim results, appraisal by NICE would help in
promoting rapid uptake. There are about 1.25 million people in England with
diagnosed diabetes. And diabetes is a killer - life expectancy is reduced by
about 20 years on average for people with Type 1 diabetes and by five to 10
years for those with Type 2.

5 Insulin glargine and other long-acting insulin analogues

The aim of insulin therapy is to replicate as closely as possible the body's
natural secretion of insulin. For many patients this requires taking a
long-acting insulin analogue together with short-acting insulin at
meal-times. Insulin glargine is a newly licensed long-acting insulin;
evidence so far is promising. Appraisal by NICE would help to promote
equitable access if it is found to be clinically and cost effective in
relation to existing treatments. About 150,000 to 180,000 patients currently
use some form of long-acting insulin analogue as part of their insulin
regime. There is evidence that insulin glargine reduces the number of
incidents of hypoglycaemia (episodes in which the level of glucose in the
blood drops to a dangerous level resulting in faintness or "black-outs").

6 Insulin pump therapy for people with Type 1 diabetes

Insulin pumps are devices which deliver insulin according to pre-set rates
under the patient's skin. They can be used to achieve and maintain
near-normal blood glucose levels. This technology offers the prospect of
significant clinical benefits to a minority of patients with Type 1 diabetes
who cannot achieve good glycaemic control by other means. Current access in
the UK is extremely variable. Appraisal by NICE would address this problem
and help ensure that treatment was available for those patients for whom it
is appropriate.
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