Letters

How much will Herceptin really cost?

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39051.733715.3A (Published 07 December 2006) Cite this as: BMJ 2006;333:1219

Balancing local and national priorities is not new

  1. Andrew Dillon (lucy.betterton{at}nice.org.uk),
  2. Peter Littlejohns, clinical and public health director
  1. 1National Institute for Health and Clinical Excellence, London WC1V 6NA

    Herceptin for early stage breast cancer is a cost effective treatment, and it is right that the NHS should make it available. The challenge of funding new treatments and balancing local and national priorities is one the NHS has faced since its inception.1 The process the National Institute for Health and Clinical Excellence (NICE) follows for evaluating new medicines is the most rigorous anywhere in the world, and local NHS organisations can have confidence that implementing our recommendations is an effective use of their resources.

    NICE's independent advisory committees do not rubber stamp decisions. They make them based on an objective and impartial interpretation of the evidence. Those who suggest otherwise should come forward with their evidence for doing so.

    It is wrong to suggest that a single recommendation from NICE will necessarily cause other services to be reduced and that these decisions are made by clinicians only. Many demands are made on available funds in any hospital at any one time and it is the responsibility of local NHS management, working with their clinical teams, to make the best use of these resources. This difficult job is made easier by NICE guidance and the support tools we offer, such as our commissioning guides and our forthcoming advice on shifting spending from less to more effective treatments.

    Footnotes

    • Competing interests: None declared.

    References

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