title: Does the National Institute for Health and Clinical Excellence only appraise new pharmaceuticals?
abstract: OBJECTIVE
  To determine the relative extent to which the National Institute for Health and Clinical Excellence (NICE) appraises new versus existing technologies, and pharmaceutical versus nonpharmaceutical health technologies.
  
  
  METHODS
  We categorized technologies within NICE appraisals published between March 2000 and June 2006 by type and classified them as new or existing using the timeline between launch in the United Kingdom and referral to NICE. We used a 3-year postlaunch cutoff to determine whether a technology was new, with a sensitivity analysis of 1 and 5 years.
  
  
  RESULTS
  We reviewed 159 technologies from 88 appraisals. Of these, 84 (53 percent) were new (sensitivity analysis 36 to 67 percent) and 75 (47 percent) were existing technologies. A total of 119 (75 percent) were pharmaceuticals, 22 (14 percent) were devices, 14 (9 percent) were procedures, and 4 (3 percent) were categorized as miscellaneous. Classification according to newness and technology type showed that 62 percent (42 to 75 percent) of the pharmaceuticals appraised were new.
  
  
  CONCLUSIONS
  By developing and applying a definition of new, we have found that the criticism of the bias toward new technologies is unfounded when applied to the appraisal program overall. At the same time, new pharmaceuticals are over-represented in the program compared with devices and procedures. This domination may cause inflationary pressures on the health service, but any wholesale move away from the technological frontier may be more costly.
authors.affiliation: Department of Public Health & Epidemiology, The University of Birmingham, UK. l.p.linden@bham.ac.uk
authors.forename: Luan
authors.initials: L
authors.lastname: Linden
authors.forename: Hindrik
authors.initials: H
authors.lastname: Vondeling
authors.forename: Claire
authors.initials: C
authors.lastname: Packer
authors.forename: Alison
authors.initials: A
authors.lastname: Cook
mesh_terms: D004864:Equipment and Supplies; D006801:Humans; D009316:National Institutes of Health (U.S.) / Q000458:organization & administration*; D009937:Organizational Objectives; D004364:Pharmaceutical Preparations; D013673:Technology Assessment, Biomedical / Q000458:organization & administration*; D014481:United States
chemical_list: D004364:Pharmaceutical Preparations