September 29th 2008, 12:42
Nobody has anything nice to say about NICE - so, being a contrarian, I will! As you may know, NICE (National Institute for Clinical Excellence) determines the drugs that should be made available on the National Health Service based upon their effectiveness and price.
Invariably it makes decisions that upset some groups, and is seen as a skinflint denying life-saving pharmaceuticals to people in desperate need. That's the rub, of course. People in desperate need a magic bullet, and are more than willing to swallow any drug company hype, whereas NICE has to take a more considered view.
The institute has hit the headlines again in the past week, this time urging doctors to reduce the prescriptions on drugs such as Ritalin for children with ADHD (attention deficit, hyperactivity disorder). It wants to see the numbers of prescriptions reduced to a third of their current levels, and reserved only for the most extreme cases.
There are a number of pressures going on here, and NICE is being the voice of reason. The first pressure is from the drug's manufacturer. Years ago, WDDTY got hold of a secret memo to the salesforce, stating that it was concerned that too few children in the UK were taking Ritalin. It was the start of a concerted drive, and, as usual, the doctors were willing accomplices.
The second pressure is from parents and doctors alike, who both see any form of errant behaviour as 'ADHD'. It's a catch-all umbrella term that captures any form of problematic behaviour that, once upon a time, was dismissed as 'boys being boys' and the like. Any excitability is exacerbated by diet, and often times the removal of sweets and processed foods from the diet will result in an almost immediate improvement to any bad behaviour.
Of course, this is not to diminish the problems of ADHD and the hell that parents of genuinely afflicted children go through. But NICE has it about right - the prescriptions need to be reduced to around a third of the level of where they are now.
It's time to stop seeing every childhood problem as ADHD in order to sell more drugs.