The Pharmaceutical Journal Vol 267 No 7177 p804
8 December 2001

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A busy week for NICE [more]
Benefits of medication reviews [more]

A busy week for NICE

The National Institute for Clinical Excellence has been much in the news this week, as we report on p807. The Department of Health used the NICE conference in London to announce that health authorities and primary care trusts would be required to implement the guidance issued by NICE. Predictably, it added that they would have to do this out of their existing budgets. NICE itself said, in addition, that it would start looking at new medicines before they are launched. Meanwhile, the Consumers’ Association has joined the chorus of groups calling for an independent review of NICE and its work.

Making NICE guidance compulsory should really should spell the end of postcode prescribing. However, there is a risk that by not allocating extra money the Department of Health may make things worse before they get better. If health authorities and primary care trusts are required to take account of national service frameworks and NICE guidance, then any activities not covered by these could be vulnerable. In addition, health authorities will need to start monitoring their compliance with NICE guidance, something they are mostly not yet doing. With the Chancellor of the Exchequer (Gordon Brown) promising an extra £1bn for the National Health Service next year, perhaps the time has come to revisit the idea of a centralised, ring-fenced pool of funding for expensive products recommended by NICE.

The other problem is "NICE blight". The announcement that a new product or category is to be reviewed by NICE has become a perfect excuse for organisations to sit on their hands, saying that they will "wait and see". Guidance on what should be done during this period would be helpful.

NICE has really arrived now and both professionals and the public have a continuing interest in what it has to say. But guidance that cannot be implemented without causing difficulties elsewhere is not worth publishing.

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Benefits of medication reviews

Researchers have found that medication reviews conducted by pharmacists are better than those carried out by general practitioners (p806). They are more thorough, they lead to more medication changes, they result in savings in medication costs, and they have no adverse effect on GP workload. The study provides further justification for pharmacists’ involvement in medicines management services. All that is now required is adequate funding.

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