Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, pursuant to the Answer of 16 October 2014 to Question 209346, what change has occurred to (a) the upper and (b) the lower end of the usual Quality Adjusted Life Year range set out in the National Institute for Health and Care Excellence's Guide to the Methods of Technology Appraisal in real terms (i) using the gross domestic product deflator, (ii) adjusting for health pay and price inflation and (iii) adjusting for the health component of the consumer price index.

It would not be methodologically sound to assess the relevance of the threshold range simply with reference to different measures of inflation. Other factors, such as rising demand for health care, are also relevant.

Independent research published by the University of York in 2013 suggests that, on the basis of spending decisions being taken in the National Health Service, it would not be appropriate to apply an inflation uplift to the National Institute for Health and Care Excellence’s (NICE) threshold range.

NICE issued supplementary advice to its Appraisal Committees on the appraisal of treatments for life extending, end-of-life treatments in January 2009. The guidance makes clearer the circumstances in which it may be appropriate to recommend the use of life-extending treatments licensed for terminal illnesses affecting small numbers of patients. NICE modified the flexibilities slightly in August 2009 to take account of issues that had arisen during their application by the Appraisal Committees.