Drug companies' lobbying of ministers has little effect on NICE

BMJ 2006; 333 doi: (Published 05 October 2006) Cite this as: BMJ 2006;333:719
  1. Andrew Jack, pharmaceutical correspondent
  1. Financial Times

    Aggressive lobbying of government ministers by drug companies seeking to overturn the judgments of the body that advises on the use of treatments by the NHS in England and Wales has had little effect on its decisions.

    Minutes of civil service meetings obtained by the Guardian (Sep 28, p 1) under freedom of information laws show that during the eight months to May this year senior executives from 10 drug companies met ministers to criticise the National Institute for Health and Clinical Excellence (NICE).

    Since its creation seven years ago NICE has been attacked by drug companies, doctors, and patients' groups whenever it recommends against reimbursement of new drugs in the NHS—largely on the grounds that their relative effectiveness is modest or their cost excessive.

    An international consensus is growing that to improve health and tackle escalating healthcare costs a more systematic “health technology assessment” is needed of precisely the sort that NICE provides.

    At a meeting in October last year, Pfizer, the world's largest drug company, hinted at disinvesting from the United Kingdom, where it has a substantial research centre at Sandwich in Kent. “Pfizer… noted that there is complacency in some quarters of Whitehall regarding their continued investment in the UK,” the minutes read.

    However, the most striking conclusion from the documents obtained by the Guardian was that drug companies' lobbying had proved largely ineffective. NICE rejected Pfizer's inhaled insulin product Exubera for NHS reimbursement and recommended its Alzheimer's drug donepezil hydrochloride (Aricept) only in very restrictive circumstances.

    Eli Lilly lobbied in vain for pemetrexed (Alimta), its treatment for the asbestos related cancer mesothelioma, and Johnson & Johnson pushed for a “fast track” approval of bortezomib (Velcade) for bone cancer, resulting in a preliminary negative opinion from NICE.

    The health department said in response to the Guardian story: “It's perfectly normal for ministers and officials to meet with a wide range of stakeholders, not only drug companies, to discuss a variety of issues. This in no way compromises the appraisal process.”


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