NICEly does it- Financial Times comment

“Probably not. But it’s worth a bloody good try.”

That was the response of Frank Dobson, then health secretary in Britain’s Labour government, to a question in 1999 about whether the new National Institute for Curbing Expenditure (NICE) would work.

Nice is the public body that recommends which treatments the National Health Service can dole out to patients. Mr Dobson sounded sceptical.

But last week the NHS constitution was launched in England (a country that has muddled through for centuries without bothering to set one down for its citizens) and Nice, which has only been around for a decade, is enshrined in it.

In its short life, the institute has made waves, both in the UK and abroad. Assessing the cost-effectiveness of drugs and diagnostic techniques is bound to court controversy. But, even if some disagree with its criteria, Nice has at the very least encouraged a national debate about how healthcare resources should be spent.

It take two to tango, though. And if Nice has brought to the UK (and some might argue to other countries as well) a new rigour in this kind of cost-benefit analysis, it has also forced drug companies to do some hard thinking of their own.

The result has been some innovative pricing of drugs. GlaxoSmithKline, for instance, has said it will bear the initial 12-week cost of a breast cancer drug, after which the NHS will foot the bill. The idea is that by then, the drug’s clinical benefit should be pretty clear. An alternative kind of risk-sharing was suggested by Novartis, with its Lucentis drug, which the Swiss drugmaker will pay for if patients need more than a certain number of injections.

At a time when the private sector is getting a thrashing, it’s good to reflect on the merits of the public sector. But what’s nice about Nice is that it’s a public-private partnership that really makes the most of both systems.


Health Direct is not surprised that the Financial Times is broadly supportive about the quango NICE, as they review it’s cost benefit analysis.

What is ignored though is that it is over four decades since unelected “experts” lost the power to bring about the premature deaths of UK citizens when the judiciary lost the power to hang criminals.

However labour’s formation of NICE has recreated the situation whereby unelected officials have the power of life or death over NHS patients by granting NICE the authority to withhold drugs which they deem to be too costly.

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