LONDON (Reuters Health) May 17 - Most British doctors would ignore guidance issued by the National Institute for Clinical Excellence (NICE) on which drugs they should prescribe if they thought it was wrong, according to the results of a survey released on Friday.
The BMA News Review survey of over 100 doctors found that 70% think the cost-effectiveness evaluation body fails to act independently. Eighty-five percent said they would ignore NICE guidance if they thought it was wrong, and 74% said they disagreed with at least one of NICE's decisions.
Bournemouth GP Malcolm Freeth told the magazine that although NICE's guidelines did not have the force of law, NICE had said that doctors who did not follow them were not very good at their job. "It puts doctors in a difficult position and GPs are getting fed up."
Other doctors in the survey said NICE was unduly swayed by the government or pharmaceutical companies.
Nottingham consultant thoracic surgeon David Beggs said NICE often wanted to reject new therapies and drugs before there had been time to examine whether they were effective.
"The only way advances are going to be made is by looking at what happens in the real world," he continued. "There are drugs which were launched in a blaze of publicity, the type NICE would have approved because they were supposed to be better and cheaper, which have completely gone out of use now because of widespread problems."
NICE executive director Anne-Toni Rodgers said NICE had received positive feedback from doctors. She said it had never received any advice from ministers on the affordability of its guidance and that if it did, it would be in the public domain.
BMA council chairman Ian Bogle said: "Part of NICE's remit is to look at cost effectiveness and therefore it is tied to the money available to the health service to some extent. So bearing that in mind, it is as independent as it can be.
"Personally, I don't think I would have enough information to disagree violently with NICE's advice. But if I thought there was a drug which could benefit a patient, and it was not deemed to be dangerous, that would override anything that NICE had said."
Meanwhile, the European Multiple Sclerosis Platform, formed of 21 national MS societies, expressed alarm at wide variations in health care in EU member states.
"We are particularly concerned about variations emerging from MS health technology appraisals," said the organisation's secretary general Christoph Thalheim.
are still waiting to know if the NHS will fund beta interferons, while
Sweden has already decided to fund them. Conversely, Viagra is freely available
to help British MS patients deal with impotence, but Sweden last month
decided not to fund it."
2001 Reuters Ltd.