According to an editorial a senior health economist in this week's British Medical Journal (BMJ), a legal challenge against *NICE (National Institute for Health and Clinical Excellence) over its decision to limit the use of drugs for Alzheimer's disease could well be an attempt to undermine its processes.

* NICE is the body that decides what treatments are supplied on the National Health Service (NHS) in England and Wales.

NICE faces a judicial review over its refusal to make part of its modeling data for the dementia drug donepezil (Aricept) available to the pharmaceutical industry. NICE insists it is crucial to protect the intellectual property rights of external assessment groups, such as the Southampton University's Health Technology Centre. Alan Maynard, Professor of Health Economics at York University, says that NICE's protection of just this part of the assessment process may be unwise - even though this lack of transparency has never been challenged before.

Maynard says that this conflict may be an attempt by the pharmaceutical industry to improve its profits from a marginally cost effective drug, and could also be part of a more subtle drive to undermine processes of assessing health technology, which are designed to make sure taxpayers receive effective treatment which is good value for money.

Maynard says similar attempts to undermine the process have also taken place in Australia, which has a similar system of assessing the cost-effectiveness of drugs and devices.

Maynard argues that NICE is essential for improving the efficiency of the NHS. He adds that NICE's processes are generally sensible and transparent. He also writes that the constraints under which it works can be improved.

Maynard writes "Surely it would have been better to have compensated Southampton for its loss of property rights in its model of treatment for Alzheimer's disease rather than become entangled in litigation. With the NHS seeking to control expenditure and target the use of drugs to improve the health of the population in a cost effective manner, and industry wanting to maximise its profits, conflict is inevitable. It is essential that the trade off between health and wealth is managed with transparent and good science by all participants - both public and private."

"Transparency in health technology assessments"
Editorial
BMJ Volume 334 pp 594-5
bmj

Edited by: Christian


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