Understanding the barriers to implementation of NICE TA 325 – Nalmefene for reducing harmful alcohol consumption
Nalmefene is a treatment option for adults with alcohol dependence who have high drinking risk levels, without physical withdrawal symptoms, and who do not require immediate detoxification. Technology Appraisal 325 was published in November 2014 and recommended nalmefene within its marketing authorisation, as an option for reducing alcohol consumption, for people with alcohol dependence when offered with ongoing psychosocial support (PSS). Since publication of TA325 adoption of nalmefene and PSS as a treatment option has been very low in England, and is used in only a fraction of the patients that NICE predicted would be eligible for the drug.
To unpick the key issues that have most likely hindered implementation of TA325 and subsequent widespread adoption of nalmefene, primary and secondary research were conducted across the Oxford AHSN region. In the sample regions involved in this work, significant variation was observed in terms of prescribing levels of the drug, the status of nalmefene in local formularies, and whether or not regions had developed and implemented suitable pathways for eligible individuals to access the drug. This work identified and explored a number of key issues and barriers that have made implementation of TA325 difficult and have prevented widespread use of nalmefene at both a local and national level.
Supporting local implementation of NICE Technology Appraisal
Alcohol dependence is now one of the biggest health problems facing the NHS today. In the past 40 years alcohol‑related...