The National Institute for Health and Clinical Excellence (NICE) is the arms-length National Health Service (NHS) agency that provides recommendations to the NHS in England and Wales on clinical practice and technologies that should or should not be used in the NHS. NICE aims to ensure that both the public and patients are included in their work and deliberations that lead to recommendations. This article provides an overview of the ways in which the public and patients can engage with NICE based upon a review of the NICE website and relevant literature. It finds that there are a range of both formal and informal mechanisms that provide an opportunity for the public and patients to be involved, but suggests that there are some improvements that could be made to improve transparency, and suggests further work to explore with the public and patients their views of how involvement should be undertaken. Lessons from the NICE experience are likely to be relevant to other countries that have or are adopting health technology assessment.

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An economic analysis of costs attributable to chronic pain in various European countries is presented. Costs include those to patients and their caregivers, health care systems, and the economy. Estimated health care expenditures for chronic pain patients in nine European countries are provided.

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area.

The overall results suggest that STAs may be faster once NICE looks at the specific product, but that there is a greater delay in the referral of STA products to NICE than for MTA products. However, the time taken for STAs is still short of the target of 9.75 months (or 39 weeks) [assuming no appeals].