§ Lord Roberts of Conwyasked Her Majesty's Government:
Whether the National Institute for Clinical Excellence will take account of the social and economic costs of rheumatoid arthritis in its assessment of anti-TNF alpha remedies. [HL1735]
§ Lord Hunt of Kings HeathThe National Institute for Clinical Excellence (NICE) carries out appraisals in accordance with its framework document. This document states that "its task is to assess the evidence of all clinical and other health-related benefits of an intervention—taking this in a wide sense, to include impact on quality of life, relief of pain, or disability etc as well as any impact on likely length of life—to estimate the associated costs, and to reach a judgment on whether on balance this intervention can be recommended as a cost-effective use of NHS and PSS resources". The detailed application of these principles is a matter for NICE itself.
§ Lord Morris of Manchesterasked Her Majesty's Government:
Further to the Answer by Lord Hunt of Kings Heath on 20 November (HL Deb, col. 999), what action they have taken to discover why three times more women than men develop rheumatoid arthritis; and what plans they have to prioritise research funding into rheumatoid arthritis. [HL1777]
§ Lord Hunt of Kings HeathThe most recent edition of theBritish Medical Journal's publication, Clinical Evidence, estimates the ratio of women to men with rheumatoid arthritis in the United Kingdom to be 2.5:1. The Department of Health is seeking advice on the evidence that is available for possible explanations of the difference in prevalence of rheumatoid arthritis in women and men.
The Medical Research Council (MRC), the main government agency that funds research into treatment and causes of disease, spent approximately £4 million on arthritis and rheumatic disease in 2000–01. The MRC does not as a rule earmark funds for particular topics: research proposals in all areas will compete for 194WA the funding available. When appropriate, high quality research in the areas the MRC is promoting may be given priority in competition for funds, but research excellence and importance to health will continue to be the primary considerations in funding decisions. The MRC always welcomes high quality applications from the scientific community for support into any aspect of biomedical research and these are judged in open competition with other demands on funding.
The Department of Health funds research to support policy and the delivery of effective practice in the National Health Service. Research on the clinical effectiveness and cost-effectiveness of anakinra for rheumatoid arthritis was recently commissioned through the Health Technology Assessment Programme. This work is being undertaken on behalf of National Institute for Clinical Excellence.
§ Lord Roberts of Conwyasked Her Majesty's Government:
Why the national service framework for coronary heart disease includes phase two diabetes but not rheumatoid arthritis, which is an equal contributor to coronary heart disease. [HL1779]
§ Lord Hunt of Kings HeathThe national service framework (NSF) was drawn up by an independent group of experts led by Professor Sir George Alberti, President of the Royal College of Physicians.
Diabetes is an important risk factor for coronary heart disease (CHD), and CHD is also the major cause of death for people with diabetes. Although rheumatoid arthritis can lead to serious heart disease, the underlying processes differ from those that commonly cause CHD, whereas the weight of clinical opinion is that diabetes is such an important risk factor that it merits specific inclusion in the NSF.