Experts on aspects of thrombosis attacked guidelines issued by the National Institute for Clinical Excellence (Nice) for lack of consultation and inappropriate use of evidence.

Dr Beverley Hunt, medical director of Lifeblood, the thrombosis charity, told the Commons health committee: “The Nice process doesn’t use experts well.”

She said specialists in the field were often excluded for fear of conflicts of interest, but those drafting drugs guidance lacked understanding of the scientific data they were reviewing.

Dr Hunt argued that suitably qualified experts should be more closely involved, and that conflicts of interest could be tackled through disclosure and excluding only those who derived more than 10 per cent of their salary from products linked to their advice.

Conflicts could be further minimised by allowing experts to act as advisers rather than formally being among the drafters of guidance, she said.

Dr Hunt’s criticisms were shared by Prof Roger Atkins from the British Orthopaedic Association, who expressed frustration that his colleagues “who have dedicated 20 to 30 years of their lives [to the subject] were simply not involved” in drafting relevant guidance.

Prof Atkins said some guidance issued last year had “very significant flaws”, and it had proved difficult to discuss and propose amendments with the Nice committee concerned.

Richard Barker, director-general of the Association of the British Pharmaceutical Industry, the trade body, endorsed the calls, but stressed that drug companies were keen to consult leading specialists when designing clinical trials.

Nancy Devlin and John Appleby from the King’s Fund, the health think-tank, called for the creation of an independent review mechanism separate from Nice to assess its cost-effectiveness threshold – similar to the Bank of England’s monetary policy committee.

http://www.ft.com/cms/s/0/5c2160b4-7e98-11dc-8fac-0000779fd2ac.html

Drugs watchdog faces legal review- NICE’s approach is irrational and flawed
http://www.healthdirect.co.uk/2006/11/drugs-watchdog-faces-legal-review.html

Health Direct notes that even the experts are questioning the deliberations of the National Institute for Curbing Expenditure.

On Fri 17 Nov 06 Health Direct posted- Drugs watchdog faces legal review- NICE’s approach is irrational and flawed

A decision by the Labour government’s drugs watchdog to restrict the use by the NHS of Alzheimer’s medication is to be challenged in court.

Two drug companies plan to apply for a judicial review of the way the National Institute for Health and Clinical Excellence reached its conclusion. NICE ruled NHS patients with newly diagnosed, mild Alzheimer’s disease should not be prescribed the drugs.

Neil Hunt, chief executive of the Alzheimer’s Society, said: “It’s great news that NICE will be challenged in court. NICE holds the fate of thousands of people’s lives in its hands and it is only right that it is brought to account.”