NICE has plenty of critics but that's hardly surprising considering the life changing nature of what they do

Critics of NICE have inevitably been most vocal at the times when treatments have been refused.

Professor John Wagstaff, writing in the Daily Mail at the time of the outcry over the drugs for kidney cancer, said that “far too often its decisions seem to be driven entirely by some arbitrary measure of cost-effectiveness rather than the best outcome for patients.”

He said that whilst the idea of NICE was a laudable one, too much of its decision making was flawed and it failed to address the real needs of suffering patients.

Another perceived problem with NICE is that it, in only considering one issue at a time, is prejudiced in favour of those which are new and expensive.

In only looking at and approving new technology it is seen as running the risk of adding to waiting lists, unintentionally discriminating against the elderly and the mentally ill.

Stuart Carroll, senior health economist, policy advisor and researcher for the Bow Group has said that improvements need to be made to ensure the organisation is seen as more in step with public opinion, however difficult that challenge may be.

He argues that it needs to take more of a multi-dimensional view to the possible benefits resulting from a particular health care intervention.

In particular he argues that NICE's decision making processes have to be seen as more ‘evaluation’ and less ‘economic evaluation’ and, when rejecting a particular drug, especially one with great public interest, it has to be more open and transparent when explaining why that course of action was taken.

http://ukpmc.ac.uk/articlerender.cgi?artid=427687