Embattled and almost friendless, the government body charged with assessing the cost effectiveness of drugs is enduring a torrid spell. The National Institute for Health and Clinical Excellence (NICE) has always been controversial, but the torrents of abuse thrown at it in the past two months have set new standards, in volume and in vitriol.

Andrew Dillon, NICE’s chief executive, has been called “Dr Death” and the organisation he runs described as “a bunch of fat cat executives who sit in their plush office playing God.” Callous, nasty, terrible, barbaric, and with “a long and devastating history of denying care to those who need it most,” NICE has run the gamut of Roget’s Thesaurus as its critics compete for the most damning adjectives the English language can provide. The British national press has run more than 200 stories about NICE since the beginning of August, all but a handful of them critical, some stretching the boundaries of reasonable comment to breaking point.

Is this a conspiracy hatched by the drug industry, stung by the often disobliging judgments of its products made by NICE? Is it a media feeding frenzy, fuelled by ministerial timidity and NICE’s own inability to rebut the criticism effectively? Or has the press actually got it right, despite its shrill and bloodthirsty tone?

NICE’s response has been to argue that rationing is inevitable …