Managing medicines: NICE

Last updated: Wednesday, July 03, 2024

NICE publishes many different types of guideline, but in this short introduction we will describe two types that pharmacists look at regularly:

1. Technology Appraisals (TAs) and Highly Specialised Technology Evaluations (HSTs). These are recommendations for medicines and treatments following a review of clinical and economic evidence. Each TA or HST commonly provides recommendations for one medicine for a specified condition, but sometimes multiple medicines for the same condition. In England, NHS organisations must usually implement a TA or HST within 90 calendar days its final publication. Essentially this means that the medicine(s) or treatment recommended in the TA must be added to the formulary and available to patients with funding and resources in place within that timeframe. Exceptions are possible if it’s not likely that the organisation would ever use the medicine(s), e.g. mental health trusts would not be expected to add a medicine for kidney transplants to their formulary.

NICE TA or HST recommendations are summarised in the BNF, and there are also summaries for patients on the NICE website. You can read more about the NICE TA programme here. NICE produce TA or HST guidance for most new medicines in England but not all. If no TA or HST is available, organisations may need to review the clinical and economic evidence themselves and decide at a local level whether or not the new medicine will be available to patients.

2. NICE clinical guidelines are recommendations on how healthcare and other professionals should care for people with specific conditions. The recommendations are based on the best available evidence. They cover the use of medicines, but also other aspects and interventions such as education, prevention, surgery, and diagnosis. You can read more detail about how these guidelines are developed here.