Leading article: Costs, benefits, and the right to know

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The Independent Online

We approved of the creation of Nice (the National Institute for Health and Clinical Excellence) and, by and large, we like the way it has exercised its authority. Judging benefit against cost is surely the right way to determine what finite amounts of public money should fund.

That said, the appeal court victory for the licence-holder of the Alzheimer's drug, Aricept, is a useful warning shot across its bows. The judges found that the process by which Nice decided to restrict NHS funding for Aricept to moderate sufferers was "procedurally unfair". The effect of that ruling was to make those in the early stages of the disease pay privately or go without. Nice's justification was that, while Aricept was beneficial for them too, it was not beneficial enough to warrant the cost.

The licence-holder Eisai complained that Nice procedures kept key elements of its calculations confidential and so put drug companies at an unfair disadvantage. It argued the companies should be entitled to know all the calculations that would affect Nice's decision.

This, of course, has dangers. Drug companies would then be able to tailor the costs of their new products in such a way as to maximise the likelihood of approval – perhaps by skewing the pricing to make some drugs less expensive, and others more.

Yet the effect could also be beneficial, in clarifying the cost-benefit equation and bringing more reasonably priced new drugs to the market. If in doubt, we would prefer a regulator that errs on the side of transparency; it is pleasing to find that this seems to be the judges' preference too.

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