The Office for Health Economics found that NICE missed its 301-day target for individual medicines in 77% of cases in the past decade. NICE also breached a 420-day target for multiple drugs in 81% of its appraisals. Appeals and legal challenges outside of NICE's control added to the delays.
The report, commissioned by Pfizer, examined 284 NICE appraisals undertaken between 2000 and 2010. On average, five years elapsed between the launch of a new medicine and a NICE ruling. The internal appraisal took an average 1.7 years, but varied from 61 days to more than six years.
The report's authors said it 'needs to be interpreted with care' because some of the drugs analysed were launched before NICE was established. But they found no evidence NICE's process had sped up over time.
GPC deputy chairman Dr Richard Vautrey said: 'It is important to gather the necessary evidence to make a considered judgment, but five years is far too long to wait. It's unfair to patients and leaves PCTs and commissioning groups exposed when making decisions.'
Dr Richard Vautrey: 'It is important to gather the necessary evidence to make a considered judgment, but five years is far too long to wait'
Andrew Chidgey, director of external affairs at the Alzheimer's Society, said GPs rely on NICE 'to remove ambiguity about a treatment and how it should be used'. 'Five years is a long time to wait,' he said. 'Whenever a new drug is available, NICE guidance should be issued as quickly as possible.'
GPC prescribing lead Dr Bill Beeby said the time taken 'frustrates everyone' but it was vital for NICE to ensure medicines are safe and cost-effective.
Yorkshire GP and former NICE adviser Dr Nick Summerton said NICE was 'constantly striving to do its best'. 'It's an impossible situation: the work is exponential.'
Manchester GP Dr Anita Sharma, a member of Oldham medicines management committee, said: 'Dealing with the current complexity of prescribing in primary care is a real challenge. Our patients trust us to make a balanced decision on their health. We are expected to have reliable evidence, competent expertise and a valid judgement before issuing a prescription. It is not fair asking us to prescribe an off-license drug. Balancing harms and benefits is essential.
'It is unacceptable NICE is taking so long to appraise a drug. I suggest NICE should think like we GPs think. Unless the drug is appraised, we cannot prescribe and patients cannot be helped. Being too busy to appraise a drug is not acceptable.'
A NICE spokeswoman said it 'doesn't recognise most of the conclusions reached' by the report and that its results were skewed by drugs licensed before NICE was established.
She said the time from licensing to first draft guidance had 'decreased dramatically' and was now four months. 'NICE works hard to ensure the NHS has access to robust guidance for medicines as soon as possible.'
- Editorial: NICE must speed up its appraisals of drugs