Is there anything nicer than NICE? A question the conservative shadow health team is right to ask

Abstract

Access to life-saving treatments, and the role played by the National Institute for Health and Clinical Excellence (NICE) in reaching decisions, continues to represent an important part of modern health policy. High profile cases and critical media coverage have sharpened public interest in this issue. In November 2008, the Conservative Party published detailed proposals on NICE outlining policies for improving the systems and processes for making decisions about NHS drug availability. The Conservatives clearly state their support for NICE, but highlight six areas to improve its configuration, structure and efficiency. These areas are consistent with the Conservative commitment to focus on health outcomes rather than central targets. A "NICE Charter" to codify the Institute's roles and responsibilities; scrapping the current system of Ministerial referral; allowing appraisals to commence at the time of drug licensing; and increasing the use of risk-sharing schemes are among the headline pledges. The policy document also makes clear the need for pharmaceutical companies to better demonstrate product clinical value by shifting the burden of proof from NICE to the manufacturer. Improved cooperation between industry and NICE is promised through the creation of a steering committee. Furthermore, a clear commitment to evaluate wider social costs and benefits is provided. The Conservative proposals make clear that there are no easy solutions to tackle the basic health economic problem of how to best allocate finite NHS resources to satisfy all healthcare needs. However, the proposals offer a solid blueprint for focused reform moving forward. © 2009, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).