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Should NICE evaluate complementary and alternative medicines?

BMJ 2007; 334 doi: (Published 08 March 2007) Cite this as: BMJ 2007;334:507
  1. David Colquhoun, professor of pharmacology
  1. Department of Pharmacology, University College London, London WC1E 6BT
  1. d.colquhoun{at}

    Demand for complementary and alternative medicine is high despite limited evidence. Linda Franck and colleagues believe that a thorough review by NICE would benefit the NHS and patients, but David Colquhoun argues that it cannot afford to re-examine evidence that has shown little benefit

    One of the most important roles of the National Institute for Health and Clinical Excellence (NICE) is to assess which treatments produce sufficient benefit that the National Health Service should pay for them. Since the money available to the NHS is not infinite, making choices of this sort is inevitable, and it is in the interests of patients that dispassionate judgments are made on the efficacy of treatments.

    If the effectiveness of a treatment is disputed, what could be more obvious than to refer it to NICE for a judgment of the evidence? Nothing is more disputed than the effectiveness of alternative medicine, so why has NICE not adjudicated? Even the Smallwood report, sponsored by the Prince of Wales, did not pretend to find good evidence, but …

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