The Pharmaceutical Journal Vol 267 No 7176 p767-773
1 December 2001

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NICE: "yes, but" rather than "no"

The National Institute for Clinical Excellence can be characterised as saying "yes, but" to new health technologies rather than just saying "no", according to a review of its first 22 reports by health economist Professor James Raftery of the Health Services Management Centre, University of Birmingham (BMJ 2001:323:1300).

Of the 22 health technologies assessed by March 2001, only three (all surgical procedures) were not recommended. Zanamivir (Relenza) was initially not recommended but this was later changed to a recommendation for use under certain conditions. Professor Raftery says that NICE cited clinical benefit in all of the 19 technologies recommended, but cited costs per quality adjusted life year (QALY) in only around half. Where costs per QALY were quoted, all but one were below £30,000.

Professor Raftery concludes: "NICE's guidance recommending the use of most technologies appraised will arguably lead to 'faster and more uniform access' to these technologies rather than to denial [of] access."

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