Has NICE been nice to cancer?

This article reviews the work of England’s National Institute for Health and Clinical Excellence (NICE) in the area of cancer treatment since it was established in 1999. NICE provides guidance to the National Health Service (NHS) in England and Wales on the clinical- and cost-effectiveness of therapeutic interventions and aims to support uniform and evidence-based care. Its most high profile work involves making judgements on whether new drug treatments should be available to NHS patients. Over 20 appraisals of anticancer drugs have now been completed by NICE; most have endorsed the availability of the reviewed agent, which is good news for cancer patients. Unfortunately, positive guidance does not, necessarily, eradicate inequalities of access.There are also concerns relating to access to drugs during the period when NICE guidance is being developed and for patients requiring treatments — often for less common cancers — which are not referred to NICE for appraisal.