The cancer technology appraisal programme of the UK's National Institute for Clinical Excellence.

The National Institute for Clinical Excellence (NICE) was established to ensure faster and more equitable uptake of new technologies by the NHS, through the provision of guidance on clinical and cost-effectiveness. The treatment of cancer is one of the UK government's priority areas and a range of guidance products have been developed by NICE to support implementation of national plans for managing patients with cancer in England and Wales. In its first 3 years, NICE's main activity was the "Technology Appraisals Programme" and it has created considerable interest and some controversy. 15 (out of a total of 56) technology appraisals related to oncology have been completed and another four are in preparation. The open, transparent, and inclusive approach NICE has adopted in reaching its decisions highlights the difficult ethical issues that need to be addressed in seeking to balance individual desires with public-health requirements. In this review we describe the process of appraising technologies, and address the recent criticism of the appraisal programme with regard to treatment of patients with cancer.