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Healthy Skepticism Library item: 9972

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

Wells J.
NICE appraisals should be everybody's business
BMJ 2007 May 5; 334:(7600):936
http://www.bmj.com/cgi/content/full/334/7600/936


Abstract:

When Newbury and Community Primary Care Trust appealed against NICE’s decision on Herceptin, it was the first to do so. Jane Wells and Claire Cheong-Leen explain the process and why other trusts should make their voices heard in appraisals of new treatments

Publicly funded health services should aim to provide the best possible health care within the available budget. With finite resources and demand for health care growing both in quantity and cost, they are faced with increasingly difficult decisions about the services they should provide. They must balance their responsibilities to the whole population and to individual patients; consider the need for preventive, therapeutic, and long term care; weigh the merits of new against established treatments; and deliver the services they wish to provide as well as those that are mandatory. In England, primary care trusts are mainly responsible for these decisions. Following the latest NHS reorganisation there are now 152 primary care trusts, each of which commissions health services for a population of up to about 600 000.

NICE and the NHS
NHS provision is fundamentally influenced by the National Institute for Health and Clinical Excellence (NICE), which produces national guidance on health technologies, . . .

Trastuzumab and beyond

Box 1: The trastuzumab story
Box 2: The primary care trust’s appeal

Greater participation

Conclusion

Summary points

 

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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