When health secretary Frank Dobson issued the National Institute for Clinical Excellence with its first two years' work programme recently, the list of drugs to be reviewed included a number which have yet to see the inside of an NHS doctor's surgery.
So who suggested it should look at the use of Glitazones in the treatment of type II diabetes, or the new Cox II inhibitors for musculoskeletal disorders?
Step forward the National Horizon Scanning Centre. Funded by the NHS Executive research and development directorate and based at Birmingham University, it aims to give the Department of Health warning of new and emerging health technologies, including new applications of existing technologies which might require urgent evaluation, consideration of cost or clinical impact or changes to clinical guidance.
It does so, as its name suggests, by scanning the horizon: pulling together intelligence from experts and professional bodies, international networks, scientific and pharmaceutical journals, the Internet and newspaper reports, hoping to spot new drugs during phase II and III clinical trials, and medical devices before they reach the market.
Some innovations can be identified up to five years before reaching the NHS.
Naturally, not all drugs and technologies will prove 'significant', and many are filtered out. Those that go on the centre's list for further assessment must be new or have new uses and be part of a group of developing technologies.
In addition, they must meet two out of four further criteria: there are major uncertainties about health benefits or cost effectiveness; they would have a major cost impact if widely adopted; they require significant service reorganisation; and they may spread rapidly because of, for example, patient or media interest.
Unfortunately, the centre has not yet published any of its reports on new technologies. Some, it says, include commercially sensitive information, and in any event their conclusions must be treated with caution since evidence at that stage is often sparse.
But it is thinking about it.