ABSTRACT
The National Health Service (NHS) is unlikely to invest in a new drug unless NICE first blesses it with a positive evaluation of its cost-effectiveness: those drugs which pass this test are guaranteed NHS adoption, and awarded a seal of approval which has international consequences. Appraisal can be a high-stakes game. This chapter charts its development. We examine the principles NICE applied to Health Technology Appraisal (HTA), the issue of its independence from government, the key cases of Relenza, Herceptin, beta interferon and drugs for macular degeneration and for Alzheimer’s disease. Interventional procedures and diagnostics are considered, and NICE’s handling of the ethical issues raised by HTA decisions.
