A written Tynwald question has revealed how long Manx Care takes to implement National Institute for Health and Care Excellence (NICE) Technology Appraisals.
Health and Social Care Minister Claire Christian published a detailed breakdown covering the past four financial years, showing significant variation between clinical areas, with oncology consistently implemented within three months, while long‑term conditions often take far longer or are not adopted when a more cost‑effective therapy is already in use.
The summary shows:
- 2022/23: 35 oncology treatments implemented; none for long‑term conditions
- 2023/24: 24 oncology; 1 long‑term condition
- 2024/25: 27 oncology; 43 long‑term conditions
- 2025/26: 33 oncology; 9 long‑term conditions
Manx Care says oncology timelines depend on Clatterbridge Cancer Centre procedures, but treatments can “be assumed to be available within three months of publication”.
Most Effective Treatment
For long‑term conditions, several NICE‑approved therapies are listed as “not in use” because Manx Care has selected a single preferred option within a therapeutic class, in line with NICE guidance to choose the most cost‑effective treatment.
The Minister’s answer includes dozens of individual publication and implementation dates across gastroenterology, dermatology, rheumatology, neurology, cardiology and urology. Some treatments were implemented years after publication.
For example, Vedolizumab (TA342) for ulcerative colitis, published in 2015, was implemented in April 2024. Others remain unused due to clinical or cost‑effectiveness decisions.
Manx Care noted that data for some cardiology patients is “complex” and would require extensive filtering beyond current resources.
The full written answer, published on July 3, forms part of ongoing scrutiny of how quickly new NICE‑approved treatments reach Manx patients.
