Healthy Skepticism Library item: 14861

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Veerman JL, Vos T.
Confusion from analyses and conflicts of interest.
BMJ 2008 Nov 25; 337:a2683:
http://www.bmj.com/cgi/content/full/337/nov25_1/a2683

Abstract:

The National Institute for Health and Clinical Excellence (NICE) is under heavy criticism for its osteoporosis guidelines.1 The National Osteoporosis Society argues that many people who would benefit from treatment are not treated and left with unnecessarily and unethically high fracture risks.

The debate is, however, confused by the combination of two factors: the manipulability of cost effectiveness analyses and conflicts of interest.

Whether a drug is funded depends partly on estimates of health gain relative to cost. Despite the existence of general guidelines,2 cost effectiveness can be estimated in many different ways. The model used for health consequences, choice of data sources, inclusion or exclusion of certain costs, and other factors influence the final results. Estimates for raloxifene, for example, differ by a factor of 10.3 4 Some of these differences arise from differences in context, but much is the result of the choices made in the process.

Keywords:
Government Agencies Great Britain Humans Osteoporosis/therapy* Practice Guidelines as Topic