Healthy Skepticism Library item: 9972

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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