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I read with interest Drummond and Mason's article and thought it
clarified the difficulties NICE clearly have in reaching fair judgements
on the cost effectiveness of new medicines. However, I was puzzled by
their solution, not withstanding their declarations of interest. As drug
companies are in business to make money, surely, it is not in their
interest to withold information that would support the introduction of
their product. Therefore if they choose not to submit it should be assumed
that either the data on cost effectiveness is unfavourable or the safety
of the drug is in question or adequate information regarding the product
is not yet available. To suggest that patients may be deprived of useful
drugs if NICE do not give a judgment in cases in which drug company
information is not forthcoming and therefore ought to approve the use,
albeit with some caveats, is to collude with the company and potentially
support the introduction of an inappropriate medcine. I would suggest NICE
follows the example of the Scottish Medicines Consortium.