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Financial interests of patient organisations contributing to technology assessment at England’s National Institute for Health and Care Excellence: policy review

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k5300 (Published 16 January 2019) Cite this as: BMJ 2019;364:k5300

Linked editorial

Patient organizations and conflict of interest

Linked opinion

Financial interests of patient organisations

Re: Financial interests of patient organisations contributing to technology assessment at England’s National Institute for Health and Care Excellence: policy review

I sat on a NICE technology appraisal committee for 10 years and Infound that patient representatives provided a vital contribution to the process. I always assumed they would give a biased opinion, since they were a selected group, irrespective as to whether they had received funding from a manufacturer. However they provided sometimes visceral insight as to what it was like to live with a disease. On one occasion , a patient described how an oral version of his treatment had markedly changed his lifestyle, compared to the previous regime of going into hospital for an infusion. On another, a patien stated he 'didn't believe the statistics that median survival was only 1.5 years since he himself had survived 2.5 years'. He then revealed that the side effects of treatment were so severe he had had to take a drug 'holiday' to be able to attend the committee meeting. These insights provided some colour to the bland statistics relating to ICERS and QALYs and in marginal cases certainly aided my decision processes. I would like to believe that, since they were clearly biased, whether or not they had financial interests did not affect my judgement.
The clinical experts, on the other hand, often had financial conflicts of interest which were declared, but it could be difficult to know their level of bias. They could be quite candid in the committee, but their reported views outside (where their paymasters could hear) were sometimes quite different!

Competing interests: No competing interests

18 January 2019
Michael J Campbell
Medical Statistician
University of Sheffield
91 Stumperlowe Hall Rd Sheffield S10 3QT