National
Institute for
Health and Clinical
Excellence (NICE):
How does it work and wHat
are tHe implications for
tHe u.s.?
Corinna Sorenson,
Michael Drummond,
Panos Kanavos and Alistar McGuire
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acknowledgements:
th\ue003 \ue000\ue010\ue00fh\ue00b\ue00d\ue00e \ue000\ue00d\ue003 \ue005\ue00d\ue000\ue00f\ue003\ue004\ue010\ue008 \ue00f\ue00b \ue00fh\ue003 n\ue000\ue00f\ue006\ue00b\ue00a\ue000\ue008 ph\ue000\ue00d\ue009\ue000\ue001\ue003\ue010\ue00f\ue006\ue001\ue000\ue008 c\ue00b\ue010\ue00a\ue001\ue006\ue008 (npc) \ue004\ue00b\ue00d \ue00c\ue00d\ue00bv\ue006\ue002\ue006\ue00a\ue005
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espe\ue002\ue004\ue001ll\ue00b \ue006eg\ue001\ue006d\ue004ng he\ue001l\ue007h \ue007e\ue002hnolog\ue004es, h\ue001s gene\ue006\ue001\ue007ed no\ue007\ue001ble deb\ue001\ue007e \ue001nd d\ue004s\ue002\ue008ss\ue004on \ue004n \ue007he u.S. \ue001\ue006o\ue008nd es\ue007\ue001bl\ue004sh\ue004ng \ue001 \ue005o\ue006e \ue003o\ue006\ue005\ue001l\ue004zed p\ue006o\ue002ess o\ue006 s\ue00bs\ue007e\ue005 \ue003o\ue006 \ue002olle\ue002\ue007\ue004ng \ue002o\ue005p\ue001\ue006\ue001\ue007\ue004\ue009e e\ue003\ue003e\ue002\ue007\ue004\ue009eness \ue004n\ue003o\ue006\ue005\ue001\ue007\ue004on. the N\ue001\ue007\ue004on\ue001l ins\ue007\ue004\ue007\ue008\ue007e \ue003o\ue006 He\ue001l\ue007h \ue001nd cl\ue004n\ue004\ue002\ue001l E\ue00a\ue002ellen\ue002e (NicE) \ue004n \ue007he u.K. \ue004s \ue007he \ue005os\ue007 d\ue004s\ue002\ue008ssed \ue001nd deb\ue001\ue007ed s\ue00bs\ue007e\ue005 \ue002\ue008\ue006\ue006en\ue007l\ue00b \ue004n ope\ue006\ue001\ue007\ue004on. NicE \ue006ep\ue006esen\ue007s \ue007he \ue005os\ue007 soph\ue004s\ue007\ue004\ue002\ue001\ue007ed n\ue001\ue007\ue004on\ue001l \ue001\ue007\ue007e\ue005p\ue007 \ue007o s\ue00bs\ue007e\ue005\ue001\ue007\ue004\ue002\ue001ll\ue00b \ue006e\ue009\ue004ew \ue007he \ue009\ue001l\ue008e, o\ue006 \ue006el\ue001\ue007\ue004\ue009e \ue002os\ue007s \ue001nd bene\ue000\ue007s, o\ue003 \ue009\ue001\ue006\ue004o\ue008s \ue007\ue006e\ue001\ue007\ue005en\ue007s. Wh\ue004le NicE h\ue001s been \ue002o\ue005\ue005ended \ue003o\ue006 \ue009\ue001\ue006\ue004o\ue008s \ue001spe\ue002\ue007s o\ue003 \ue004\ue007s \ue006e\ue009\ue004ew \ue001nd \ue001pp\ue006\ue001\ue004s\ue001l p\ue006o\ue002esses, \ue003\ue006o\ue005 \ue007he \ue004n\ue002l\ue008s\ue004on o\ue003 s\ue007\ue001keholde\ue006s \ue007o \ue006\ue004go\ue006o\ue008s \ue008se o\ue003 e\ue009\ue004den\ue002e, \ue004\ue007 h\ue001s no\ue007 ope\ue006\ue001\ue007ed w\ue004\ue007ho\ue008\ue007 \ue002on\ue007\ue006o\ue009e\ue006s\ue00b. con\ue002e\ue006ns \ue001bo\ue008nd \ue006eg\ue001\ue006d\ue004ng \ue007he \ue005e\ue007hods e\ue005plo\ue00bed d\ue008\ue006\ue004ng \ue007he \ue001pp\ue006\ue001\ue004s\ue001l \ue001nd \ue006e\ue009\ue004ew p\ue006o\ue002ess, \ue007he \ue006ole \ue001nd \ue008\ue007\ue004l\ue004\ue007\ue00b o\ue003 \ue002os\ue007-e\ue003\ue003e\ue002\ue007\ue004\ue009eness e\ue009\ue004den\ue002e \ue004n de\ue002\ue004s\ue004on-\ue005\ue001k\ue004ng, \ue001nd \ue007he \ue006es\ue008l\ue007\ue004ng \ue004\ue005p\ue001\ue002\ue007 on o\ue008\ue007\ue002o\ue005es \ue001nd \ue001\ue002\ue002ess \ue007o he\ue001l\ue007h \ue002\ue001\ue006e.
in b\ue006o\ue001d \ue007e\ue006\ue005s, NicE se\ue006\ue009es \ue001s \ue001n \u201c\ue001\ue006\ue005s-leng\ue007h\u201d o\ue006g\ue001n\ue004z\ue001\ue007\ue004on \ue007h\ue001\ue007 p\ue006o\ue009\ue004des n\ue001\ue007\ue004on\ue001l g\ue008\ue004d\ue001n\ue002e on \ue007he p\ue006o\ue005o\ue007\ue004on o\ue003 good he\ue001l\ue007h \ue001nd \ue007he p\ue006e\ue009en\ue007\ue004on \ue001nd \ue007\ue006e\ue001\ue007\ue005en\ue007 o\ue003 \ue009\ue001\ue006\ue004o\ue008s he\ue001l\ue007h \ue002ond\ue004\ue007\ue004ons. Spe\ue002\ue004\ue000\ue002\ue001ll\ue00b, NicE\u2019s \ue006e\ue005\ue004\ue007 \ue004s \ue007o \ue002ons\ue004de\ue006 bo\ue007h \ue002l\ue004n\ue004\ue002\ue001land \ue002os\ue007-e\ue003\ue003e\ue002\ue007\ue004\ue009eness \ue004n de\ue009elop\ue004ng \ue004\ue007s g\ue008\ue004d\ue001n\ue002e. When \ue004\ue007 w\ue001s es\ue007\ue001bl\ue004shed \ue001nd d\ue008\ue006\ue004ng \ue007he \ue005\ue001jo\ue006\ue004\ue007\ue00b o\ue003 \ue004\ue007s e\ue00a\ue004s\ue007en\ue002e, NicE h\ue001s p\ue006od\ue008\ue002ed \ue007h\ue006ee \ue007\ue00bpes o\ue003 g\ue008\ue004d\ue001n\ue002e, \ue004n\ue002l\ue008d\ue004ng technology appraisals, clinical guidelines, \ue001nd
reg\ue001\ue006d\ue004ng \ue004\ue007s \ue006ole \ue004n he\ue001l\ue007h \ue002\ue001\ue006e de\ue002\ue004s\ue004on-\ue005\ue001k\ue004ng, NicE g\ue008\ue004d\ue001n\ue002e essen\ue007\ue004\ue001ll\ue00b se\ue006\ue009es \ue001 q\ue008\ue001s\ue004-l\ue001w \ue003\ue008n\ue002\ue007\ue004on \ue004n \ue007he N\ue001\ue007\ue004on\ue001l He\ue001l\ue007h Se\ue006\ue009\ue004\ue002e (NHS) \ue001nd b\ue006o\ue001de\ue006 he\ue001l\ue007h \ue002\ue001\ue006e s\ue00bs\ue007e\ue005. Beg\ue004nn\ue004ng \ue004n J\ue001n\ue008\ue001\ue006\ue00b 2005, \ue007e\ue002hnolog\ue00b \ue001pp\ue006\ue001\ue004s\ue001ls \ue001\ue006e s\ue008ppo\ue006\ue007ed b\ue00b \ue005\ue001nd\ue001\ue007e, \ue004n \ue007h\ue001\ue007 \ue007he NHS \ue004n Engl\ue001nd \ue001nd W\ue001les \ue001\ue006e e\ue001\ue002h now leg\ue001ll\ue00b obl\ue004g\ue001\ue007ed \ue007o p\ue006o\ue009\ue004de \ue003\ue008nd\ue004ng \ue003o\ue006 \ue005ed\ue004\ue002\ue004nes \ue001nd \ue007\ue006e\ue001\ue007\ue005en\ue007s \ue006e\ue002o\ue005\ue005ended b\ue00b NicE. Spe\ue002\ue004\ue000\ue002\ue001ll\ue00b, \ue004\ue003 NicE g\ue008\ue004d\ue001n\ue002e s\ue008ppo\ue006\ue007s \ue007h\ue001\ue007 \ue001 p\ue001\ue006\ue007\ue004\ue002\ue008l\ue001\ue006 \ue007e\ue002hnolog\ue00b be \ue005\ue001de \ue001\ue009\ue001\ue004l\ue001ble b\ue00b \ue007he NHS \ue007o \ue001 \ue002e\ue006\ue007\ue001\ue004n p\ue001\ue007\ue004en\ue007 g\ue006o\ue008p(s), \ue007hen \ue001sso\ue002\ue004\ue001\ue007ed he\ue001l\ue007h \ue002\ue001\ue006e o\ue006g\ue001n\ue004z\ue001\ue007\ue004ons \ue001\ue006e obl\ue004g\ue001\ue007ed \ue007o \ue004\ue005ple\ue005en\ue007 s\ue008\ue002h \ue006e\ue002o\ue005\ue005end\ue001\ue007\ue004ons. mo\ue006eo\ue009e\ue006, NHS o\ue006g\ue001n\ue004z\ue001\ue007\ue004ons \ue001\ue006e \ue006eq\ue008\ue004\ue006ed \ue007o do so w\ue004\ue007h\ue004n \ue007h\ue006ee \ue005on\ue007hs o\ue003 \ue007he d\ue001\ue007e \ue007he g\ue008\ue004d\ue001n\ue002e \ue004s \ue004ss\ue008ed.
\ue006e\ue002e\ue004\ue009es s\ue008gges\ue007ed \ue007op\ue004\ue002s \ue003\ue006o\ue005 \ue001 n\ue008\ue005be\ue006 o\ue003 so\ue008\ue006\ue002es. in gene\ue006\ue001l, \ue007he Dep\ue001\ue006\ue007\ue005en\ue007 o\ue003 He\ue001l\ue007h (DH) \ue002o\ue005\ue005\ue004ss\ue004ons NicE \ue007o de\ue009elop \ue002l\ue004n\ue004\ue002\ue001l g\ue008\ue004del\ue004nes, g\ue008\ue004d\ue001n\ue002e on p\ue008bl\ue004\ue002 he\ue001l\ue007h, \ue001nd \ue007e\ue002hnolog\ue00b \ue001pp\ue006\ue001\ue004s\ue001ls, wh\ue004le \ue007op\ue004\ue002s \ue003o\ue006 \ue007he \ue004n\ue007e\ue006\ue009en\ue007\ue004on\ue001l p\ue006o\ue002ed\ue008\ue006es p\ue006og\ue006\ue001\ue005 \ue001\ue006e s\ue008b\ue005\ue004\ue007\ue007ed d\ue004\ue006e\ue002\ue007l\ue00b \ue007o NicE, \ue008s\ue008\ue001ll\ue00b b\ue00b \ue002l\ue004n\ue004\ue002\ue004\ue001ns. Howe\ue009e\ue006, \ue007op\ue004\ue002s