Intended for healthcare professionals

Rapid response to:


Open letter raises concerns about NICE guidance on statins

BMJ 2014; 348 doi: (Published 11 June 2014) Cite this as: BMJ 2014;348:g3937

Rapid Response:

Re: Open letter raises concerns about NICE guidance on statins

Concerns about conflicts of interest (COI) in NICE guideline groups have been raised in the recent statin proposals. But this is the norm not the exception for authors of NICE guidelines who are often steeped in COI, for example, Hypertension, Diabetes and Depression.[1,2,3] These of course are chronic incurable common conditions that is the financial life blood of the Pharma Industry balance sheets.

Regrettably institutions like NICE dismiss these COIs, claiming that as long as these are declared, they do not impact on the advice given. This of course is a nonsense and those looking from outside are bemused that experts with COI are allowed to be involved in such important guidance. Experts on the take from Pharma companies believe that medication “works” , so have a closed therapeutic mindset, never questioning the current paradigm of medical care. Medications are always the solution to all problems medical or social .

Indeed there other conflicts of interests that are non financial. Academics have their own careers to carve out, empires to build and pet theories to disseminate. Being on NICE gives credence and status. So even expert academics without links to Big Pharma are by no means truly impartial. So we have the known knowns of academic bias; the known unknowns of academic bias but also unknown unknowns, the ones we don't know we don't know! The road to medical truth is barricaded by squat-set-balaclava- -bowtied thuggish experts touting professorships and heavy biases! And we don’t really need experts, for most medical research at its core is so basic that having O level statistics would make you over qualified.

NICE is over complicated, flat-footed, bureaucratic, opaque and addled by conflicts of interest, financial and otherwise. Big Pharma and vested specialist interests lurk malevolently in the shadows of many a guideline. Yet these guidelines directly affect our families' medical care, everywhere and everyday. Is NICE fit for purpose? We need to tear it down and start again with a system that actively prohibits all conflicts of interest and is less reliant on a select few experts.

[1] NICE Diabetes Group
[2] NICE Hypertension Group
[3] NICE Depression Group page 600

Competing interests: No competing interests

13 June 2014
Des Spence
General Practice
Maryhill Health Centre G20 9DR