NICE at 10 years: new challenges ahead.

NICE has existed for 10 years. During this period, its methodological approach to developing guidance and assessing the value (cost-effectiveness) of healthcare interventions has received considerable national and international interest. At the same time, individual decisions have generated enormous controversy. This 10th anniversary provides an opportunity to look back at how the institute has responded and adapted to the various challenges and controversies. Following Lord Darzi's review of the National Health Service (UK) in 2008, the institute took on further responsibilities for setting clinical standards for the National Health Service. This article explores these developments and speculates on future trends.