BMJ defends UK's NICE legal challenge

In an editorial, the British Medical Journal has expressed its support for the UK's National Institute for Health and Clinical Excellence (NICE), in the latter's legal challenge (Marketletter November 27) by Japan's Eisai (wrongly referred to in the BMJ editorial as a US drugmaker). The dispute arose over the NICE's recommendation to restrict the use in the National Health Service to Eisai's Alzheimer's diseases treatment Aricept (donepezil), which it co-markets with the USA's drug giant Pfizer, except in cases of "moderate," as opposed to early or late AD.

Fiona Godlee, the BMJ's editor, wrote that the NICE was "under attack from US drug companies, apparently with White House backing." She added: "what this shows is not that [the] NICE is in trouble but that it is doing its job."

Despite these views, the BMJ editorial admits that "the current process is flawed because NICE guidance doesn't state what treatments must be cut when new treatments are recommended." The solution proposed is for the NICE to be given the authority to rule on cuts in other treatments to fund the new drug, or the power to allocate additional resources to pay for a new therapy.