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Healthy Skepticism Library item: 8984

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

Maynard A.
Transparency in health technology assessments
BMJ 2007 Mar 24; 334:(7594):594
http://www.bmj.com/cgi/content/full/334/7594/594


Abstract:

Should NICE have the right to refuse access to its modelling data?

The running battle over which National Health Service patients with dementia should have access to the dementia drug donepezil (Aricept) is to progress to the courts. Last year, guidance from the National Institute for Health and Clinical Excellence (NICE) restricted use of the drug to patients with moderate and severe Alzheimer’s disease, thereby denying its use for 60% of patients with Alzheimer’s disease who have mild dementia.1

NICE’s decision was based on modelling Aricept’s clinical and cost effectiveness through a contract with Southampton University’s Health Technology Centre. NICE makes its own internal work accessible to the drug industry so that its processes are open to critical appraisal. Furthermore, it requires industry to supply all its evidence in an “executable” form, so that differing assumptions can be modelled. However, NICE’s appraisal guide clearly states that the contracted work of external academic assessment groups, such as the Southampton University’s Health Technology . . .

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909