NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
HEALTH TECHNOLOGY APPRAISAL PROGRAMME
Equality impact assessment – Guidance development
STA Baricitinib for severe alopecia areata
The impact on equality has been assessed during this appraisal according to the principles of the NICE equality scheme.
Consultation
- Have the potential equality issues identified during the scoping process been addressed by the committee, and, if so, how?
During scoping, the following were identified:
Beard hair loss: religious implications e.g. Sikh and Jewish faiths. Many standard treatments are more challenging for beard hair loss, systemic medication may be needed earlier in the treatment pathway.
Adolescents with severe alopecia areata: management very challenging and increasing available treatments would have significant impact.
Disease duration cut-off <8 years: lead possibly to age discrimination.
Alopecia areata may be more common in people of Asian family background, lower socioeconomic status and urban location. Referral to secondary care in these groups is lower.
Limited number of tertiary care hair specialist dermatologists in UK. Limiting drug availability to tertiary centres may lead to geographic inequalities.
Some health-related quality of life measures may not adequately capture impact of living with health conditions in older people or those who are not in a relationship or capture anxiety and depression across all groups. May discriminate against non-native English speakers.
The committee included a paragraph in the draft guidance noting some of these issues but that they had not affected the committee’s conclusions.
Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of baricitinib for treating severe alopecia areata Issue date: February 2023
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- Have any other potential equality issues been raised in the submissions, expert statements or academic report, and, if so, how has the committee addressed these?
No.
- Have any other potential equality issues been identified by the committee, and, if so, how has the committee addressed these?
The only other additional issue identified by the NICE technical team is the use of the Severity of Alopecia Tool as the main outcome in the submission. This tool focuses only on scalp hair loss. This issue is highlighted in the draft guidance.
- Do the preliminary recommendations make it more difficult in practice for a specific group to access the technology compared with other groups? If so, what are the barriers to, or difficulties with, access for the specific group?
No.
- Is there potential for the preliminary recommendations to have an adverse impact on people with disabilities because of something that is a consequence of the disability?
No.
- Are there any recommendations or explanations that the committee could make to remove or alleviate barriers to, or difficulties with, access identified in questions 4 or 5, or otherwise fulfil NICE’s obligations to promote equality?
No.
Technology appraisals: Guidance development
Equality impact assessment for the single technology appraisal of baricitinib for treating severe alopecia areata Issue date: February 2023
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- Have the committee’s considerations of equality issues been described in the appraisal consultation document, and, if so, where?
Yes, paragraph 3.15.
Approved by Associate Director (name): ……Janet Robertson……………………
Date: 20/02/2023
Technology appraisals: Guidance development Equality impact assessment for the single technology appraisal of baricitinib for treating severe alopecia areata Issue date: February 2023
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