Call to abolish UK's "barbaric" National Institute for Health and Clinical Excellence

The UK's National Institute for Health and Clinical Excellence (NICE) is facing calls for its abolition after it first refused to recommend four drugs to be used in the treatment of metastatic renal cell carcinoma (Marketletter August 11) and then recommended that the National Health Service should not save patients "if it costs too much," arguing that the government-funded health care provider should not behave like rescue services trying to save a sailor lost at sea.

NICE ignores its own citizens council

The NICE has been under pressure to apply the "rule of rescue," setting aside costs in instances where treatment is necessary to save life. But the Institute, which recommends the adoption of medicines and best clinical practice in the UK, apart from Scotland, has decided that if drugs are too expensive they should not be prescribed even if they prolong life, because the money could be better spent elsewhere. The controversial judgement overrides advice from the agency's own citizens council, which recommended in 2006 by 21 votes to six, two years ago that it should adopt the "rule of rescue" on humanitarian grounds. The council was made up of members of the public chosen to be representative of opinion outside the medical profession.