Nasty question for Nice

The new National Institute for Clinical Excellence is right to ask for more facts about Relenza, Glaxo Wellcome's new flu drug (page 64). For the GP, few prospects are worse than a drug that encourages everyone in the early, infectious stages of flu to head for the surgery. Unless Relenza is very good indeed, it could be the biggest boost ever to the spread of the flu virus.

But the questions Nice has to deal with will become more complex. Much as new legislation has to be tested in case law, its position on clinical effectiveness and on cost-effectiveness will need to be established by example, especially when it rules on whether undoubtedly effective treatments are affordable.

Sir Richard Sykes of Glaxo Wellcome - and the other drug companies supporting his stand - is right that Nice's appearance may have fundamental effects on research in the United Kingdom. The industry's success owes much to the purchasing power of the National Health Service and to staff in the NHS and medical schools in testing and trialling treatments.

But Sir Richard's warning that thwarting Glaxo's sales hopes for Relenza could be fatal for the UK as a home for drug innovation is unattractively bullying. The company is poised to cut 1,700 British jobs, but in manufacturing, not research. The UK, with its huge NHS testbed, will remain an attractive research base. However, collaboration between the NHS, universities and companies has been eroded by closer accounting for time and money in academe and the NHS. The UK's world position in biomedical research needs careful handling if companies, patients and the economy are not to suffer.