Box 2.

The National Institute for Clinical Effectiveness [22]

Objective:	To provide patients and health professionals with robust and reliable guidance on ‘best practice’ covering both individual health technologies (e.g. medicines) and the clinical management of such conditions.
Targets:	Recent technologies appraised include hip prostheses, taxanes for ovarian cancer and breast cancer, coronary stents, proton pump inhibitors for dyspepsia, hearing aids, Zanamivir (Relenza) flu, and Rosiglitazone for type 2 diabetes
Mechanisms:	– Independent assessment of published evidence;
	– Verbal and written submissions from public/carer organisations, professional organisations and manufacturers;
	– Evaluation report with consultation and appeals period;
	– Guidance issued on level of use in NHS
Examples:	Taxanes for ovarian cancer
	– access to the product has varied considerably across NHS
	– NICE concluded that when a woman reaches an ‘appropriate stage’ in her ovarian cancer she should be offered Taxane. The guidance would allow 1000 additional women to benefit at a cost of around £7 m
	Zanamivir (Relenza) flu
	– should not be used by an otherwise healthy individual
	can be used for those at risk when flu is present in the community and patients can start medication within 48 hours of their symptoms starting