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NICE and the British National Health Service

Steven D. Pearson, MD, MSc; Michael D. Rawlins, MD

JAMA. 2005;294:2618-2622.

The National Institute for Health and Clinical Excellence (NICE) was established as a part of the British National Health Service in 1999 to set standards for the adoption of new health care technologies and the management of specific conditions. In doing so it was required explicitly to take into account both clinical effectiveness and cost-effectiveness. This article describes how NICE has responded to the challenge and considers whether its experience of balancing quality, innovation, and value for money holds policy lessons for the United States.

Author Affiliations: National Institute for Clinical Excellence, London, England (Drs Pearson and Rawlins); Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass (Dr Pearson); and Wolfson Unit of Clinical Pharmacology, University of Newcastle, Newcastle upon Tyne, England (Dr Rawlins).

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