NICE in Conflict-of-Interest Controversy

They say the road to hell is paved with good intentions. The row in the UK over NICE’s call to doctors to increase the use of statins looked to be good example of this handy aphorism. That was until things took a potentially darker turn.

NICE has said that any healthy person with a 10 per cent risk of suffering a heart attack or stroke within the next decade should be taking a statin. Currently those with a 20 per cent risk are prescribed the drug.

With cardiovascular disease killing one in three people, NICE’s proposals “are intended to prevent many lives being destroyed,” said Prof Mark Baker, director of NICE’s centre for clinical practice.

This week however a group of eight signatories, including the President of the Royal College of Physicians and a past chair of the Royal College of GPs, published an open letter to NICE and the UK government’s Health Secretary, Jeremy Hunt, warning that the statin guidance will “medicalize” up to five million health people.

The benefits of statins do not outweigh the side-effects, the signatories believe, warning that patients will be unnecessarily exposed to diabetes, memory loss, and muscle pain, among other conditions. What’s more, they went on, NICE’s research reveals an “over dependence” on industry data. “Extensive evidence shows that industry-funded trials systematically produce more favorable outcomes than non-industry sponsored ones.”

Today the Daily Mail and others took this industry-bias bone and ran with it. Half of the 12-strong expert panel advising NICE on the statins, the Mail declared, “have financial ties to drugs firms making the pills”.

The panel’s chairman, Dr Anthony Wierzbicki, claims the Mail, “has been given funds likely to total tens of thousands of pounds from five drugs firms which make statins or similar cholesterol-lowering pills”.  Dr Rajai Ahmad, Cardiologist at Sandwell and West Birmingham Hospitals, “has been paid by Bayer, Boehringer Ingelheim and MSD to give speeches or offer advice”. Even the panel’s senior nurse, Emma McGowan, was reportedly financially supported by AstraZeneca for the first year of her job at Coventry and Warwickshire Hospital, as well as being ”paid by Merck, which also makes statins, to give speeches to nurses.” And so on.

NICE is used to facing backlash over its recommendations and refusals. It might have been amusing to see it face similar criticism over urging the NHS to spend more on a particular treatment. But the conflict-of-interest accusations might prove the undoing of its good intentions in this case.