Legal challenge may be attempt to undermine NICE

Armen Hareyan's picture
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A legal challenge against the National Institute for Health and Clinical Excellence (NICE) over its decision to restrict the use of drugs for Alzheimer's disease may be an attempt to undermine its processes, warns a senior health economist in this week's BMJ.

NICE, the body that decides what treatments are supplied on the NHS in England and Wales, faces a judicial review over its refusal to make part of its modelling data for the dementia drug donepezil (Aricept) available to the pharmaceutical industry.

NICE argues that this is essential to protect the intellectual property rights of external assessment groups (in this case, Southampton University's Health Technology Centre). But this lack of transparency has never been challenged before, and although NICE's rules might be noble, protection of just this part of the assessment process may be unwise, writes Alan Maynard, Professor of Health Economics at York University.

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He argues that this conflict may be an attempt by the drug industry to enhance its profits from a marginally cost effective drug, and might also be part of a more subtle drive to undermine processes of assessing health technology, which are designed to ensure the delivery of effective treatments to patients and value for money to tax payers.

Australia has a similar system of assessing the cost effectiveness of drugs and devices and attempts have also been made to undermine its processes.

NICE is an essential institution for improving the efficiency of the NHS, writes Maynard. Generally its processes are transparent and sensible. However, the constraints under which it works can be improved. Surely it would have been better to have compensated Southampton for its loss of property rights in its model of treatment for Alzheimer's disease rather than become entangled in litigation?

He concludes: "With the NHS seeking to control expenditure and target the use of drugs to improve the health of the population in a cost effective manner, and industry wanting to maximise its profits, conflict is inevitable. It is essential that the trade off between health and wealth is managed with transparent and good science by all participants

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