§ Mr. GrayTo ask the Secretary of State for Health what plans he has to issue further guidance on facilitating patient access to influenza treatments. [147204]
§ Mr. DenhamWe have no such plans at present.
46W
§ Yvette CooperIn 1999–2000 the average cost of a mastectomy can be classified in a number of ways dependent on whether the mastectomy performed is partial, full, etc. Not all mastectomies are performed due to breast cancer, and no differentiation is made for the reason behind the surgery.
In activity terms, this can be classified using a number of Office of Population, Censuses, and Survey codes, such as
- B272: Total mastectomy and excision of both pectoral muscles
- B273: Total mastectomy and excision of both pectoralis minor muscle
- B274: Total mastectomy
- B275: Subcutaneous mastectomy.
In cost terms, these OPCS codes map to Healthcare Resource Groups (HRGs), which put these procedures into clinically similar bands. For the 1999–2000 financial year, the national average cost of the groups, including mastectomy, are:
§ Mr. GrayTo ask the Secretary of State for Health for what reasons he issued recommendations to implement a patient group direction and a telephone triage system which resulted in the supply of only Relenza treatment. [147074]
§ Mr. DenhamThe intention of the supplementary guidance issued to the National Health Service by the Department was to provide practical advice on implementing the National Institute for Clinical Excellence recommendations on zanamivir. This included advice on arrangements for general practitioners to draw up arrangements to enable pharmacists and nurses to supply zanamivir, provided they are satisfied the patient is in the at-risk group, needs it and meets specified criteria.
This guidance was issued to the NHS in the light of the potential implications for the delivery of GP services over the winter period.
§ Mr. GrayTo ask the Secretary of State for Health, pursuant to his answer to the hon. Member for North Wiltshire of 19 December 2000,Official Report, column 143W, on Relenza and Lysovir, what estimates have been made of the annual cost of prescribing (a) Relenza and (b) Lysovir to at-risk adults when influenza is circulating in the community. [147075]
§ Mr. DenhamThe Department has made no estimate of the annual cost prescribing of(a) Relenza and (b) Lysovir to at-risk adults when influenza is circulating in the community
However, the National Institute for Clinical Excellence estimates that its guidance on Relenza (zanamivir) will result in between 97,000 and 487,000 at-risk individuals 47W being prescribed zanamivir in the influenza season, at a cost to the National Health Service in England and Wales of between £2.3 million and £11.7 million.
§ Mr. GrayTo ask the Secretary of State for Health for what reasons his Department endorsed NICE guidance on the use of Relenza for at-risk patients. [147162]
§ Mr. DenhamThe National Institute for Clinical Excellence's (NICE's) task is to appraise the clinical and cost effectiveness of treatments, based on the available evidence.
In response to NICE's guidance on the use of Relenza, the Department issued supplementary implementation guidance to the National Health Service in the light of the potential implications for the delivery of GP services over the winter period. This guidance was not an endorsement of Relenza.
§ Mr. GrayTo ask the Secretary of State for Health for what reasons Lysovir was not used as a comparator by NICE in its technology appraisal of the clinical and cost effectiveness of Zanamivir in the prevention and treatment of influenza. [147073]
§ Mr. DenhamIt is for the National Institute for Clinical Excellence to decide the appropriate comparisons to be used for the appraisals which they are asked to carry out.
§ Mr. GrayTo ask the Secretary of State for Health if he will ask for the NICE guidance on Relenza to be enforced when clinicians have in place clinically acceptable alternative arrangements for the treatment of patients. [147076]
§ Mr. DenhamWe expect general practitioners to exercise their clinical discretion in deciding whether and what to prescribe, taking due account of guidance from the National Institute for Clinical Excellence. The exercise of clinical discretion is not overridden by NICE guidance.
§ Mr. GrayTo ask the Secretary of State for Health what assessment his Department has made of the comparative cost and clinical effectiveness of Lysovir and Relenza. [147071]
§ Mr. DenhamThe Department has made no such assessment.