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Influenza drug to undergo "fast track" assessment by NICE

Judy Jones , BMJ

The influenza drug zanamivir (Relenza) will undergo "fast track" appraisal by the new National Institute for Clinical Excellence (NICE), which will recommend which treatments should be available on the NHS in England and Wales. Zanamivir is said to moderate the symptoms of flu and shorten bouts of the illness.

Professor Sir Michael Rawlins, the institute's chairman, said last week that he hopes to publish recommendations on the use of the drug this autumn. Thereafter, the first tranche of treatments scheduled for evaluation includes the taxane drugs for ovarian and breast cancer, hip replacements, asthma inhalers for children, interferon beta for multiple sclerosis, and routine wisdom tooth extraction. NICE will also issue guidelines for doctors and patients showing best practice "pathways of care" in the management of back pain, pressure sores, and schizophrenia.

The UK government established NICE as a special health authority earlier this year with a remit to provide the most authoritative advice to ministers and the NHS on the clinical effectiveness of drugs and other treatments used. The intention is to make decision making by doctors and health authorities more evidence based. Frank Dobson, the secretary of state for health, wants to end the so called "postcode lottery," which denies many patients certain treatments simply because of where they live. "By identifying which new developments most improve patient care, NICE will help spread good practice and new treatments quickly across the NHS," he said. "It will help protect patients from outdated and inefficient treatment and ensure that the NHS gets the best possible value for money."

Professor Rawlins pointed out that there were currently around 60 types of hip prostheses on the market, priced from £200 to £2000 apiece. There was a clear need for independent and systematic evaluation of these and many other treatments to replace "the old ad hoc arrangements," he said. Vivienne Nathanson, the BMA's head of science, ethics, and health policy, commented that there may be occasions when NICE guidelines would not be appropriate for particular patients. "We will be advising doctors to record their treatment decisions in the patient's notes to show that they have considered the guidelines," she said.

Further details can be found on NICE's website (www.nice.org.uk).

(Credit: NHS) Professor Sir Michael Rawlins: chairman of NICE