Editorial - NICE must speed up its appraisals of drugs

The ability to benchmark practices against each other on achievement was made easier when the QOF was introduced in 2004. Suddenly, the DH had a points-related measure applying to all UK practices which had been negotiated with the GPC.

Last month, GP revealed exclusively that European Commission proposals to speed treatment access would mean funding decisions by bodies, such as NICE, would have to be made within 120 days for new drugs (GP, 11 April). As we reveal today, this may be a problem for NICE because just 23% of single technology appraisals meet its own assessment target of 301 days and just 19% of multiple technology appraisals met its 420-day target.

The reaction to our original story seemed counterintuitive - both the GPC and Cancer Research UK warned that imposing strict deadlines on NICE's decisions could force the institute to accelerate its work, making it more likely to reject expensive drugs.

NICE is exempt from the current EU directive but UK ministers are considering this in the light of the proposals.

Just like the current QOF for practices, an EU target would give us a government-backed measure by which to judge the performance of NICE. However, there are many other possible outcomes of this switch to consider. Ordinary GPs may welcome the bid to speed up NICE's decision-making, perhaps enabling patients to receive the best treatment available to them more quickly. But what if speeding up the process encouraged NICE to say 'no' more often?

Clinical commissioning groups might actually welcome the financial breathing space such a surely unintended outcome might allow them.

It is NICE's performance that must give cause for concern and we should be less concerned about outcomes. By its own measure, it is taking longer than it should to make decisions. It must surely raise its game.

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