NICE의 설립과 변화를 통해 살펴본 영국 보건의료기술평가의 발전 배경과 과제

Abstract

NICE is the most influential health technology assessment (HTA) organization in the world. This study reviews the brief history of NICE and explores how an institution like NICE has been created and expanded its role, interacting with the institutional and socioeconomic environment. Factors that contributed to the UK’s health technology assessment system include its long-standing empirical academic tradition, effective mobilization of human resources through changes in research and development strategies, the influence of medical publications such as BMJ and Lancet and their support for HTA, and the centralized health care system. NICE, which was created to solve the “postcode lottery” issues, has faced several challenges since its launch, but its achievement are recognized both domestically and internationally and has continued to expand the scope of its activities. Political circles have been able to avoid responsibility for uncomfortable decisions by taking technocratic approaches, and NICE has gained some recognition from stakeholders by emphasizing transparency and communication with stakeholders from the beginning of its establishment. However, because rationing itself is a political decision, the controversy surrounding the NICE appraisal has continued, and NICE has several challenges at hand.