Jul 23 2004
The National Institute for Clinical Excellence is creating inflationary pressure that the NHS cannot afford, argue researchers in this week's BMJ.
Responding to an article on the rationale behind NICE decisions, Professor Alan Maynard and colleagues say that giving NICE a real budget would encourage it to examine the effect of its decisions on the whole NHS.
NICE exists to give health professionals advice on providing their NHS patients with the highest clinical standards of care. Its approach to economic evaluation is based on affordability, efficiency and equity, yet the authors suggest that this approach has been self serving and inflationary.
They believe that NICE's role is too peripheral to the NHS. Instead, NICE should inform NHS decision making and provide better information on the equity implications of new and existing technologies. It should also focus not only on service enhancement but also on withdrawal of existing ineffective or inefficient therapies.
Give NICE a real budget, they say. This would force it to examine the cost effectiveness of existing treatments as well as new ones and to prioritise and fund the excessive demands they are making on local NHS budgets.
The NHS cannot afford NICE generosity, even with increased NHS funding. Over the next few years the current substantial growth in NHS expenditure is likely to fade, and NICE will have to make hard choices in a much more difficult economic climate, they conclude.