The National Institute for Clinical Excellence has voted unanimously to increase the transparency of its appraisal process by publishing its provisional recommendations on its website.

It will now consult with stakeholders and the Financial Services Authority, and the results of the consultation will be reported to the January meeting of the board.

In the meantime, the existing arrangements will continue.

NICE says that the requirement for confidential handling of evaluations was introduced at the request of the healthcare industry, namely the Association of the British Pharmaceutical Industry and the Association of British Health-care Industries, which represents medical technology manufacturers, as they felt that premature release of provisional decisions could be share-price sensitive and might create unnecessary anxiety for patients.

But following the leaks of several of its decisions, notably the recent case of taxanes for breast cancer, NICE has decided that a greater degree of openness is required.

Professor Sir Michael Rawlins, chair of NICE, said: 'It was clear to the board that the current position regarding confidentiality is unsustainable. There are large numbers of people involved in the consultation process, and while NICE can guarantee the integrity of its own processes we can't control what others might do; therefore confidential documents have been regularly leaked.

This is not in the interests of either the institute or patients.'

But the ABPI said that NICE's decision to publish its provisional recommendations before the final decision has been made was 'deeply flawed'.

Dr Trevor Jones, director-general of the ABPI, commented: 'We are entirely supportive of transparency with regard to NICE's decisions, but it must be transparency at the right and proper time, not a premature rushing into print.'

The ABPI says it is concerned about the issue of information which can have a negative impact on companies' share prices, and which can be particularly important for small companies operating in high-tech therapeutic fields.

NICE this week gave the goahead for the limited prescription of the anti-flu drug Relenza for those over 65 or with chronic respiratory or cardio-vascular conditions. NICE estimates that over 500,000 people will be eligible for the drug at a cost of over£11m.

GPs have warned that it will place a burden on workload at a time when they are already stretched.

Health minister John Denham welcomed the decision and announced NICE's new work programme. Among others, the treatments to be evaluated are nicotine replacement therapy and bupropion for smoking cessation; antipsychotic drugs for schizophrenia; anti-D prophylaxis for pregnant women; Infliximab for Crohn's disease and rheumatoid arthritis;

Etanercept for rheumatoid arthritis; and inhaler devices for older children with asthma.

It will also consider Ramipril for heart disease.