ArticleSociology of health & illness2026
Inside the 'Black Box' of Pharmaceuticalisation: NICE, the Permissive Principle and the Case of Anticoagulants.
Article in Sociology of health & illness, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Inside the 'Black Box' of Pharmaceuticalisation: NICE, the Permissive Principle and the Case of Anticoagulants.Sociology of health & illness · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sociological interest in pharmaceuticalisation continues to grow, especially regarding the expansion of pharmaceutical use in society. This article presents the first major empirical study focusing on the directionality of pharmaceuticalisation by taking cost-effectiveness assessment and regulation of anticoagulants in England by the National Institute of Health and Care Excellence (NICE) as a case study. During this century, anticoagulant therapy for the prevention of stroke and systemic embolism has changed direction profoundly away from warfarin towards newer and markedly more expensive direct oral anticoagulants. Drawing on established theoretical frameworks of pharmaceuticalisation, together with years of documentary research, interviews and observations of stakeholder meetings, it is demonstrated that this directional change cannot be adequately accounted for solely by reference to biomedicalism. Rather, such change must also be explained by key sociological factors, including the adoption of the permissive principle towards the newer drugs by the NICE regulatory system, pharmaceutical industry influence on governance processes, the 'coincidence' of expansion in diagnostic criteria for stroke risk with the introduction of the new direct oral anticoagulants, and the promotion of neoliberal patient choice and innovation by the regulatory state. Finally, the generalisability and policy implications of our findings for other therapeutic and institutional contexts are considered.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.