NICE has always been anxious to ensure that the data on which it
bases its advice, and its processes, are transparent. We want to do
this for two reasons. First, it is right in principle for
health professionals and the public to know the basis on which we
reach our decisions. Although there will be times when others will
disagree with our judgement about the advice we give this should be
on the basis of shared information. Second unless we are transparent
with our processes we will neither earn or retain the confidence of
the public or the professions.
Neverthelesas we have two problems.
Some of the material provided by individual companies may be given to
us "In Confidence". Whilst we make every effort to get their
approval for us to disclose important data (and many companies have
done so even when our final advice has not been to their
satisfaction) it may not invariably be the case in the future. We
have contemplated refusing to accept data which is not, or cannot be
put, in the public domain. To do so, however, may deny us the
opportunity to undertake a full evaluation of the available evidence;
and thus may result in us giving advice that is not in the best
interests of patients. We do not pretend to be comfortable with this
but it is a reality which we cannot ignore. We would also almost
inevitably fall foul of the law; as a public body, NICE's advice can
be subject to judicial review and to deny anyone the opportunity to
make a "Confidential" submission would be in breach of "natural
justice".
We have made no secret of the fact that we would have wished both our
provisional and final appraisal advice, on the use of particular
technologies, to be published on our web-site (www.nice.org if you
dont know it). We have been persuaded from doing so, so far, at the
request of relevant manufacturing industries because of the potential
impact on share prices. Whilst many on the maibase will find this
difficult to accept, there is a real issue for us because of the
requirements of the Financial Services Act.
As Andrew Dillon (NICE chief exec) stated yesterday we are exploring
mechanisms to overcome this. We do, badly, wish to avoid such
problems in the future. Dont lose faith in us yet!
Professor Sir Michael Rawlins
Wolfson Unit of Clinical Pharmacology
The University
Claremont Place
Newcastle upon Tyne NE2 4HH
United Kingdom
Tel: 44 191 222 8041
Fax: 44 191 232 3613
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