The Skin Care Campaign is to appeal against the NICE Final Appraisal Determination on the frequency of application of topical corticosteroids for atopic eczema (published 06.05.04), which rules that where more than one alternative topical corticosteroids is considered clinically appropriate within a potency class, the drug with the lowest acquisition cost should be prescribed.

“Since the announcement of this appraisal there have been serious concerns that it is a cost-cutting device aimed at applying restrictions to the prescribing of topical corticosteroids for patients with eczema; these concerns are borne out by the ruling,” comments Peter Lapsley, chief executive, Skin Care Campaign.

“NICE has acted without its remit to appraise the frequency of application of topical steroids,” Lapsley explains. “The final appraisal document also rules on which topical corticosteroids should be used, yet at no point did NICE seek evidence for the relative efficacy or cost-efficacy of the 30 treatments under consideration!

“The lack of evidence-base makes this ruling a blatant infringement of clinician and patient choice,” concludes Lapsley.

SCC is also concerned that there was no dermatologist on the Appraisal Committee and only three people with any expertise on the subject – a dermatologist, a nurse consultant in dermatology and a representative of the National Eczema Society – were selected from clinical and patient advocate nominations to participate in the Appraisal Committee’s discussions, to inform deliberations.

The Skin Care Campaign is an umbrella organisation representing the interests of all people with skin diseases in the UK . Established in 1992, it is a subsidiary of the National Eczema Society, a registered charity, which is also one of its members.

It recommends that because everybody’s skin is different and different people react differently to different treatments, the widest possible range of treatments should be available on prescription at appropriate levels within the NHS. The NICE ruling clearly contravenes this basic clinician and patient right.