Summary
This Report,
'National
Institute for Health and Clinical Excellence’ (HC 27), looks at the role of
National Institute for Health and Clinical Excellence (NICE), how the
organisation works, changes made since its establishment and the new challenges
it faces.
Healthcare systems throughout the world have suffered
from a lack of clear, authoritative advice about clinical matters and
cost-effectiveness. They have been confronted by multiple, often conflicting,
guidelines on the use of medical technologies and variations in patients'
access to care depending on where they live. NICE was established in 1999 to
address these problems in England.
There is much evidence that NICE carries out many of its functions
effectively. However, there are criticisms of slow release of guidance and
perceived unfairness in NICE's recommendations.
The Committee identifies
several problems with the evaluation process, including:
- Topic
selection
- Failure to include wider benefits of treatment to society
- Lack of information needed to make a full assessment
- Insufficient use of appropriate experts
- Slow publication of
guidance.
One of the Committee’s key recommendations is the need
for a system whereby all medicines are assessed at launch. NICE should also
have access to the information used by the licensing authority and should work
closer with the pharmaceutical industry. The affordability of NICE guidance and
the threshold it uses to decide whether a treatment is cost-effective is of
serious concern.
The Committee recommends a review of the threshold and
makes a number of recommendations concerning implementation of NICE guidance.
Better mechanisms are needed to ensure that the NHS pays a fair and affordable
price for medicines and NICE should be involved in any new system. The
Committee concludes that NICE does a vital job in difficult circumstances.
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