Memorandum submitted by the National Institute
for Clinical Excellence (NICE), following the evidence session
of 16 January
Professor Gordon McVie
I am writing to correct the erroneous information,
given by Professor McVie, in his evidence to the Select Committee
on Science and Technology.
1. NICE has already issued technology appraisal
guidance on the use of:
chronic lymphocytic leukaemia
2. The Institute is currently appraising:
chronic myeloid leukaemia
3. The Institute's appraisals are conducted
vigorously and fairly, taking into account both clinical and cost
effectiveness. Moreover, as part of its appraisal process, the
Institute seeks advice from relevant health professionals (including
oncologists in the case of anti-cancer drugs) and patient/carer
organisations (eg CancerBACUP).
4. The Institute accepts that, in the past,
there has been unacceptable variation in the provision of medicines,
including anti-cancer drugs. Indeed, this was one of the reasons
for the establishment of the Institute. NICE has therefore embarked
on a series of appraisals of anti-cancer drugs which, as you can
see, is now well advanced. At the time that NICE was established
(April 1999) there were, however, many other health technologies
(quite apart from anti-cancer drugs) that were subject to "post
code" variability and we have consequently been required
to devote considerable attention to this "backlog".
In this context, the Committee should be aware that NICE's work
programme is set by the Department of Health and the National
Assembly for Wales; the Institute does not, itself, have powers
to decide the priorities for appraisals.
5. In order to avoid the re-emergence of
"post code" prescribing the Institute is anxious for
its appraisals of significant new technologies to be completed
within three months of their appearance on the market.
6. The Committee will be aware that the
implementation of NICE guidance is the responsibility of health
authorities and trusts. The Institute is conscious that, in the
past, there have been occasions when NICE guidance has not been
as rapidly implemented as we would have wished. We therefore support
the Government's recent Directive that places an obligation on
health authorities and trusts to fund NICE's appraisal guidance.
Professor McVie is aware of all these issues
and I regret that his remarks may have misled your Committee.
I would, of course, be pleased to set the record straight in person
if this were appropriate.
Professor Sir Michael Rawlins
ChairmanThe National Institute for Clinical
18 January 2002