Health Inc.

Unpleasant Future Looms For Britain's NICE

Critics of one of the most controversial parts of the British health system may lose their target in a few years.

The National Institute for Health and Clinical Excellence (happily called NICE by critics and supporters alike) decides whether medicines are cost-effective.  If NICE says a drug provides too few benefits at too high a price, the National Health Service in England and Wales generally won't provide the drug.

At a drug industry trade group meeting in London earlier this week, Health Minister Lord Howe, Under Secretary of State for Quality, said NICE has become "redundant," and that it should focus on setting quality standards rather than evaluating individual drugs.

NICE has been held up by American critics as an example of what happens when the government rations medical care. There have been complaints that Brits dying of cancer weren't able to get the latest treatments. Another controversial decision from NICE led to restrictions on Alzheimer's drugs that are now being relaxed.

Many folks in England and Wales accept NICE's decisions without complaint, but others have railed against them. The national government as well as local divisions of the National Health Service have on occasion overridden NICE.

Meanwhile, in another blow to the agency’s reputation, the government has said that it's providing £200 million ($318 million) to the NHS to pay for several cancer drugs that NICE has deemed unworthy.

Lord Howe says NICE's advice will still be taken into consideration. But some close watchers of NICE are predicting the agency will be gone by 2013.

While NICE's loss of power would deny headline writers some of their best chances for bad puns, the drug industry may not be completely off the hook.

Lord Howe says the government is working on a new agency that would set drug prices based on a "value-based pricing system." With no details yet available, that could be good news or bad news for drug companies.

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