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Industry outlines concerns with NICE to Parliament

Published on 24/05/07 at 12:34pm

NICE's shortfalls have compromised public confidence in the cost and clinical-effectiveness body, the pharmaceutical industry has told MPs.

The comments were submitted to the Health Select Committee for its second inquiry into the way NICE works. Over the next six months, the committee will hear from pharma companies, patient groups, doctors and NICE itself.

In its first submission to the inquiry, the ABPI praised NICE's core strengths - including its stakeholder engagement and independence from pricing decisions  and outlined a broad range of concerns.

These included NICE's unnecessarily adversarial approach to industry; issues of quality and consistency in work commissioned from its review and advisory groups and an over-reliance on the cost per QALY (quality adjusted life-year) in its decision-making.

Commenting shortly before the ABPI's evidence was made public, its director general Dr Richard Barker said: "This is the year when people will take a very hard look at NICE.

"Although NICE is one of the most advanced health technology assessment systems, the most advanced is not that advanced."

In its own submission to the Health Select Committee, NICE said it had a worldwide reputation for producing credible and robust guidance through a thorough, fair, transparent and inclusive process.

" It is in the nature of the work that NICE does that its advice will sometimes be controversial. After all, our purpose is to help the country to decide on the best use of the resources it devotes to the health service; resources which are, although increasing, invariably limited," it said.

The institute said that rather than there being more challenges to its decisions, it was conscious of an increase in the media's reporting of them.

The committee's areas of investigation include:

* why NICE's decisions are increasingly being challenged;

* whether public confidence in the Institute is waning, and if so why;

* NICE's evaluation process, and whether any particular groups are disadvantaged by the process;

* the speed of publishing guidance;

* the appeal system;

* comparison with the work of the Scottish Intercollegiate Guidelines Network (SIGN);  the implementation of NICE guidance, both technology appraisals and clinical guidelines (which guidance is acted on, which is not and the reasons for this).

The next oral evidence sessions will be held on 28 June and 12 July, with the committee likely to continue taking evidence into the autumn.


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