National Institute for Health and Clinical Excellence

In this book I will share with you the process by which I came to this conclusion and the scientific evidence on which it is based. This includes evidence that was known to the pharmaceutical companies and to regulatory agencies, but that was intentionally withheld from prescribing physicians, their patients and even from the National Institute for Health and Clinical Excellence (NICE) when it was drawing up treatment guidelines for the National Health Service (NHS) in the UK. 

In the decade that has passed since our article was published, the dust has settled around the issue of meta-analysis. It is no longer considered a controversial procedure. Meta-analyses of clinical trials are now routinely published in all of the top medical journals, and the National Institute for Health and Clinical Excellence (NICE), which publishes the treatment guidelines that are used by the NHS, crafts recommendations on the basis of meta-analyses that it conducts. Nevertheless, the editors were right about our article being controversial. Although some scholars in the field were persuaded by our analyses, others were sceptical, to put it mildly.2 The sceptics knew that antidepressants worked - if we had found otherwise, we must have done something wrong. Certainly there were other clinical trials of antidepressants beyond those that we had included in our analyses. Surely an analysis of those studies would point to a different conclusion. 

Morisky DE, Green LW, Levine DM (1986) Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 24 67-74 NICE Guidance (2008) National Institute for Health and Clinical Excellence. Guidance Medicines concordance. http //www.nice.org.uk/guidance/index.jsp action=byID o=l 1638. Cited 30 Dec 2008... 

The precise role of economic evaluation varies among countries. In the vast majority of jurisdictions the role is confined to decisions about pharmaceuticals only, although the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom also considers devices, medical procedures, and public health interventions. Even among those countries considering only pharmaceuticals, there are variations in policy. In some, all new pharmaceuticals are considered, whereas in others only those drugs having a premium price, or likely to have a major impact on the health care system, are evaluated. 

Guidelines published include those of the National Institute for Health and Clinical Excellence in England and Wales on managing dyspepsia in primary care. 

National Institute for Health and Clinical Excellence. The clinical effectiveness and cost-effectiveness of infliximab in Crohn s disease. Technology appraisal TA040. Available from URL www.nice.org.uk... 

National Institute for Health and Clinical Excellence. Hepatitis B (chronic) - adefovir dipivoxil and peginter-feron alpha-2a. Technology appraisal TA096. [2006], Available from URL www.nice.org.uk National Institute for Health and Clinical Excellence. Hepatitis C peginterferon and ribavirin. Technology appraisal TA106. [2006]. Available from URL WWW. nice. org. uk... 

NICE (National Institute for Health and Clinical Excellence) (2006). Hypertension - management of hypertension in adults in primary care. Available at http //www.nice. org.uk/download.aspx o=cg034NICEguideline [Accessed 3 July 2008]. 

The ASCOT trial (Dahlof et ah, 2005) recommends using ACE inhibitors first line for younger patients and calcium channel blockers for older patients. The National Institute for Health and Clinical Excellence (NICE, 2006) recommends ... 

National Institute for Health and Clinical Excellence. Antenatal and postnatal mental health clinical management and service guidance—NICE Guidance, February 2007 http //guidance.nice.org.uk/CG45. 

National Institute for Health and Clinical Excellence. CG23. Depression management of depression in primary and secondary care—NICE Guidance, December 2005 http //gui-dance.nice. org.uk/CG23. 

---