NICE and the SMC

The National Institute for Health and Clinical Excellence (NICE) is responsible for providing guidance to the NHS in England and Wales on certain drugs and specifically whether or not they consider these drugs to be sufficiently cost effective to be provided on the NHS. Cost effectiveness is determined by examining whether treatments have in patients sufficient effect when compared to alternatives to justify additional cost to the NHS.

Recent decisions NICE has made not to recommend certain cancer drugs for use in the NHS that are widely accepted by clinicians to be important additions to their existing range of treatments, and which are routinely prescribed throughout Europe. These decisions have raised questions about whether NICE’s current processes are suitable for all types of cancer.

We believe that improvements need to be made to the speed of NICE’s appraisal process, the threshold at which it decides whether a drug constitutes value for money for the NHS and whether it contains appropriate flexibility to make the right judgements about drugs for which evidence is lacking, such as rare cancers or cancers with generally poorer outcomes.

There are also broader issues about how NICE’s decisions are implemented in local hospitals and surgeries across the UK which need to be addressed.

Decisions on which drugs will be made available in Scotland are the responsibility of the Scottish Medicines Consortium (SMC). The SMC process differs from NICE in that it doesn’t include a public consultation phase, basing its decisions on submissions from manufacturers alone. However, many of the same principles of appraisal and issues about implementation also apply to the Scottish system.

More information on NICE and the SMC is available on our CancerHelp UK webpages.