Systems for evaluation of new drugs in the United Kingdom.

The cost of drugs represents 10% of the National Health Service (NHS) budget in the UK and this fraction is increasing. Because the NHS is centrally funded and because there is a budgetary limit, prioritization in health care is required. The National Institute for Clinical Excellence in England and Wales and the Health Technology Board for Scotland have been established with the aim (among others) of ensuring that the NHS secures maximum health gain from available resources by focusing on treatments with clear evidence of cost effectiveness. Reconciling the interests of those responsible for financing the service with the interests of patients and other concerned parties might prove difficult.