The Pharmaceutical Journal Vol 267 No 7177 p805-809
8 December 2001

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Independent review of NICE sought

The Consumers’ Association wants an independent review of the National Institute for Clinical Excellence and greater involvement of patients in its work.

The Consumers’ Association held a public inquiry into NICE attended by over 40 patient groups. It made three recommendations. First, an independent review of NICE taking into account the interests of patients as well as those of the pharmaceutical industry and the National Health Service. The National Audit Office has been suggested to undertake this review.

Secondly, the association wants more clarity and openness in the way that NICE conduct its appraisals. Clara Mackay, principal policy adviser at the association said: "There is a lack of information about the methodologies used and the weight that is placed on different types of evidence. NICE could act on this recommendation immediately in order to eliminate some of the confusion surrounding the appraisal process".

The third recommendation is that patient groups should be better supported in order to be able to take part in the NICE appraisal process.

Concerns were raised from patient groups about the adequacy of the evidence used in the NICE appraisal process. It was suggested that NICE may put too much emphasis on information obtained from clinical trials without considering quality of life measures. Outcome measures used in clinical trials might not be those that are most important to patients. The fact that patients with long-term medical conditions do not necessarily use a medicine at the same frequency throughout their illness was also raised. It was thought that this may have financial implications with regard to the way in which NICE estimates the cost of treatments to the NHS.

NICE says that the institute has always made the details of the processes it follows available to the public and full details of the appraisal process are published on its website, alongside guidance for patient and
carer organisations on preparing their submissions.

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