BMJ  2004;329:740-741 (25 September), doi:10.1136/bmj.329.7468.740-b

Letter

NICE and its value judgments

Favourable appraisal amounts to compulsory purchase order

The first 150 words of the full text of this article appear below.

EDITOR—The role of the National Institute for Clinical Excellence (NICE) in reducing the postcode lottery is limited by the denial of its legitimate role in healthcare rationing.^{1 2} The focus on new and expensive drugs, and the requirement by the government that NHS bodies implement NICE guidance within three months, seriously skew local priorities.

The use of sales data to monitor the uptake of a NICE approved drug militates against an orderly and considered uptake of new technologies. A favourable NICE appraisal amounts to a compulsory purchase order. The agenda is therefore set not by NICE but by those who apply to NICE for their products to be appraised.

The reason why NICE has not appraised yoga or transcendental meditation for stress and hypertension, or a lifestyle intervention involving 3-4 kg weight loss and 150 minutes of moderately vigorous physical activity a week as a "technology" that cuts the . . . [Full text of this article]

North Birmingham Primary Care Trust, Birmingham B44 8BH Jammi.Rao@northbirminghampct.nhs.uk

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