National Institute for Health and Clinical Excellence
Auteur: Great Britain: Parliament: House of Commons: Health Committee
Nombre de pages: 117 pages
ISBN: 0215037960, 9780215037961
Edition: The Stationery Office
Date de publication: The Stationery Office
Description: Healthcare systems throughout the world have suffered from a lack of clear, authoritative advice about clinical 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. The National Institute for Clinical Excellence (NICE, since 2004 the National Institute for Health and Clinical Excellence) was established in 1999 to address these problems in England. This report looks at what NICE does, how it works, changes made since its establishment and the new challenges it faces, and examines the evaluation process, implementation, and drug pricing. There is much evidence that NICE carries out many of its functions effectively. But 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; not having all the information needed to make a full assessment; experts are not sufficiently well used; publication of guidance is slow. A key recommendation 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 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.