Examination of Witnesses (Questions 211
WEDNESDAY 23 JANUARY 2002
211. May I welcome our second group of witnesses?
We appreciate your co-operation with our inquiry and we are grateful
for the written evidence we have received. Would you each briefly
introduce yourself to the Committee, starting with you, Mr Gray?
(Mr Gray) My name is Eddie Gray. I am
General Manager for GlaxoSmithKline in the UK. The Committee has
asked GlaxoSmithKline to appear as a separate witness but, for
the Committee's information, we are members of the ABPI and I
am currently a member of its Board of Management.
(Mr McKinney) Hugh McKinney, a founder Director of
Campaign for Effective and Rational Treatment (CERT).
(Mr Campbell-Morrison) David Campbell-Morrison from
Campaign for Effective and Rational Treatment.
(Mr Fullagar) I am Bill Fullagar, currently President
of the ABPI and Chairman of Novartis Pharmaceuticals.
(Dr Jones) I am Trevor Jones. I am Director General
of the ABPI.
(Dr Patterson) John Patterson. I am President-elect
of the ABPI and a member of the executive team of AstraZeneca.
212. I am not sure whether you were present
for the first session, but you will be aware we began by asking
questions about the independence of NICE. I should be very interested
to know your own views from different perspectives on whether
NICE is genuinely independent. If it is not, why is it not and
what reasons do you have for saying it is not?
(Mr Fullagar) NICE is not independent in so far as
its agenda is set for it by somebody else.
213. Presumably you mean the Government.
(Mr Fullagar) By the team the Government puts together
to feed the agenda into it. It then has to deal with what it is
handed and when it has finished that, then it hands out its recommendation
in one direction or another but has no control over the way that
advice is used at the current time. Thus far it does not have
the freedom either to set its own agenda or to see that its recommendations
are put into effect.
(Mr Gray) Yes, our experience would be similar. The
determination of the agenda and list of appraisals that NICE does
are clearly something which is handed to them and is not something
for which they take independent action. In our experience in the
appraisal process itself they do demonstrate independence in review
of appraisals and the recommendations they make.
214. What about this point which came out in
the previous session and also from some of the written submissions
we have that the pharmaceutical industry is far too close to NICE?
One of the areas where some of the witnesses were saying that
NICE is influenced in particular is by the Department of Health
and by the industry that many of you here represent.
(Dr Patterson) NICE have been directed by the Department
of Health to assess on most occasions new technologies and 70
per cent of those have been new medicines. The industry has usually
just spent 10 or 12 years and $350 million developing those medicines
and clearly has most of the expertise and most of the knowledge
at that time on that medicine. Not surprisingly therefore, we
are heavily consulted on it, but we are not at all consulted on
which medicines are chosen, nor are we part of the assessment
process, nor do we have, other than submitting the evidence and
being able to provide that, any means of influencing the decision
215. Forgive me for appearing a bit naive, but
as somebody who rarely has a day without an invitation from your
industry to do one thing or another, usually involving dining
or wining or something, are you telling me that there is no kind
of attempt to shape the process of an evaluation in the interests
of the people some of you represent here, the commercial interests?
(Dr Patterson) My belief is that NICE fiercely guards
its independence and we would respect that independence.
216. You respect the independence.
(Dr Patterson) Yes.
217. Basically you are saying that there is
no attempt to press them in a certain direction favourable to
some of your members.
(Dr Patterson) Individual members respond on individual
technologies. When it is guidelines, then several members will
218. You say they "respond". They
do not initiate.
(Dr Patterson) They are invited to submit data.
219. There would be no means whereby they off
their own bat or their own volition would make representations
of concern. This is in response to a specific invitation to be
part of that evaluation process.
(Dr Patterson) Not part of it, to submit evidence
to that evaluation process.