On Wednesday 9 January 2008, the House of Commons health select committee published the report of its second inquiry into the National Institute for Health and Clinical Excellence (NICE).1 The committee’s first inquiry into NICE was published six years ago,2 just three years after the institute’s launch. Much has happened since the initial inquiry. The institute is now well established and is a core policy driver within the National Health Service in England and Wales (its remit does not cover Scotland), and we know much more about how it operates. Moreover, the working environment of the institute has changed with, for instance, the publication of the Cooksey report on funding for health research in the United Kingdom,3 the introduction of legislation making NICE technology appraisals essentially compulsory,4 the involvement of the courts in a legal challenge to NICE,5 and most recently the Office of Fair Trading’s critical review of how brand name drugs are priced in the UK through the Pharmaceutical Price Regulation Scheme (PPRS).6

All these and more have been embraced …