Abstract
The role of the various agencies involved in the managed introduction of new drugs in the United Kingdom is discussed, particularly with regard to the work of the National Institute for Clinical Excellence (NICE). The process by which the National Health Service in the UK identifies key new drug technologies of major clinical, financial and service significance is discussed. This includes the decision making process for selection of products for appraisal by NICE. The appraisal procedure and the impact of NICE guidance for the NHS will, it is hoped, encourage quality in clinical practice. All healthcare systems face budgetary constraints and the introduction of new technologies bring particular challenges. The launch of the new biological agents for the treatment of rheumatoid arthritis, into a speciality where previously relatively inexpensive agents were prescribed, raises questions concerning managed introduction and reimbursement.