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Radical proposal to revamp NICE

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The threshold used by the National Institute for Health and Clinical Excellence (NICE) on whether to approve drugs on the NHS has “no basis”, a study claims.

NICE is an independent body that decides which drugs should be available on the health service in England and Wales.

But since its inception in 1999, NICE has adopted a cost-effectiveness threshold range of £20,000 to £30,000 per quality adjusted life year (QALY) gained.

The Commons Select Committee inquiry into NICE has received evidence that this range may be too generous.

If this is correct, it means that NICE has recommended too many new drugs and the efficiency of the NHS is being compromised.

Now John Appleby, chief economist at the King’s Fund, and colleagues Nancy Devlin and David Parkin, at City University in London, claim a radical solution is needed.

Their study, published in the British Medical Journal (BMJ), recommends that the NHS be given independence from the Department of Health when setting the cost-effectiveness threshold.

They say this will work in a similar way to the manner in which the Bank of England has operational independence from the Treasury so that it can set UK interest rates to contain inflation.

Copyright © PA Business 2007

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