The (possible) impact of comparative effectiveness research on pharmaceutical industry decision making.

Public and private payers in rich and emerging economies are becoming increasingly interested in using evidence to inform health-care resource allocation decisions. The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom has been doing so on behalf of the National Health Service (NHS) for more than 10 years. To some, NICE-type entities are barriers to access and innovation. Increasingly, however, even NICE's critics appreciate that evidence-informed decision making, carried out in a fair, inclusive, and transparent way, is better than arbitrary government-imposed price cuts. For health-care systems in developed and developing countries around the world, faced with limited budgets, there may be no third option.