Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what rationale lies behind NICE's advice that end-of-life criteria should only apply to medicines that extend life by at least three months.

In January 2009, the National Institute for Health and Care Excellence (NICE) issued supplementary advice to its appraisal committees on appraising treatments which may be life-extending for patients, with short life expectancy, and which are licensed for indications affecting small numbers of patients with incurable illnesses.

This sets out the following three criteria that must all be satisfied for this supplementary advice to be applied:

- the treatment is indicated for patients with a short life expectancy, normally less than 24 months;

- there is sufficient evidence to indicate that the treatment offers an extension to life, normally of at least an additional three months, compared to current NHS treatment; and

- the treatment is licensed or otherwise indicated, for small patient populations.

These criteria were developed following public consultation and set out the circumstances when NICE considers it is appropriate for its appraisal committees to apply greater flexibility in their appraisal of these treatments.

The advice has now been incorporated chapter 6 of Guide to the methods of technology appraisal 2013 which can be found at:

www.nice.org.uk/article/pmg9/chapter/6-the-appraisal-of-the-evidence-and-structured-decision-making