Content area
Full Text
The National Institute of Clinical Excellence (NICE) is responsible for providing guidance to the National Health Service in England and Wales on the clinical- and cost-effectiveness of medicines and medical technologies. In 2002, NICE commissioned a series of internal reviews of their work, while an external review was carried out by the WHO Regional Office for Europe.
The WHO team of experts reviewed a series of technology appraisals and carried out extensive discussions with NICE staff, members of the Appraisal Committee and Technical Assessment Groups and other stakeholders during the course of two visits to NICE in 2003.
NICE was established as a Special Health Authority to address the introduction and use of new technologies and medicines within the United Kingdom National Health Service (http://www.nhs.uk.). The Review Team recognized that - in only four years - NICE had developed a well-deserved reputation for innovation and methodological development that represents an important model for technology appraisals internationally.
Achievements that are particularly valuable include:
* transparency surrounding the process of technology assessment.
* participation of different stakeholders and the inclusiveness of the approaches taken.
* commitment to using the best available evidence for decision-making.
* commitment of the technical and management staff.
* dedication of the appraisal team and Committee members.
The Review Team made the following recommendations which were drawn up with the aim to enhance operations within NICE and assist organizations with similar responsibilities in other countries. The full rassessment eport is avalable on: http://www.nhs.ukand http://www.nice.org.uk
Recommendations
The principles
* NICE should continue to develop operational procedures that are consistent with its core principles of transparency, consultation and inclusiveness with respect to stakeholders' involvement in evidence- gathering and decision-making. The NICE model of partnership in the scientific endeavour of health technology appraisal offers valuable international leadership.
* NICE should seek to reconcile the inherent contradiction between its principles of transparency and its acceptance of evidence for the decision-making process that a stakeholder deems to be confidential. NICE should continue the work already started on this issue to ensure that all material submitted for consideration can be made available to the public.
* The principle of transparency requires that NICE codifies and justifies the specific criteria used in decision-making. Difficult but important elements of this task...