N I C E Cancer Drug Rejection

[Zacs-Master]

How can the above organisation be all for promoting Clinical Excellence when they reject a new drug. Where does the 'Excellence' fit in to that scenario?

[Zacs-Master]

Thankyou daffy.

[black_cat51]

it's clinical excellence. If a drug has limited benefits for only a small amount of people, the clinically correct thing to do is to not give it to people.

[Mamyalynne]

Please accept my condolences too Zacs.


It does indeed seem cruel beyond belief that decisions have to be made using financial constraints but it will ever be so.


If only the funding could keep pace with the new drugs developed.

[Zacs-Master]

Thanks mamy.

[Old_Geezer]

Excellence but within the bounds of feasibility / affordability. They don't write blank cheques with our money, especially when it looks like it can be used better elsewhere in the medical arena.

[Sqad]

Interesting, this word "Excellence", a word that was never used in the NHS until late 1970's. Hospitals suddenly described various departments as "Centres of Excellence" and when one inquired who decided on that accolade, nobody seemed know.

NHS is state controlled medicine and NICE is a government body, comprised of eminent men with valuable merit awards to add to their salary.....they like turkeys are not going to vote for Christmas, but they do have a budget to adhere to.

Other European countries have sanctioned the use of the drug.

Six months extra life is average, some with advanced metastatic cancer may live for a year....minimal side effects.......would you want an extra 6months to a year of extra life?

I would.

[Svejk]

who wouldn't sqad? but where shall we draw a line. £180,000, £500,000, 5 million?
Personally I'd take a small part of the £billion a month that goes to the bottomless pit of Foreign Aid and treat all the women.(as someone else suggested) Certainly while this country is borrowing money.

[Hypognosis]

My condolences Zacs.

[Sqad]

Svejk.....you make a good point, but you are dealing with a system which spends £120 billion.............

[black_cat51]

however, there are thousands of people who feel their quality of life would be improved by having breast enlargement, or gender re-assignment, but people wouldn't expect the NHs to pay, and public opinion wouldn't make any difference to the "excellence" of those decisions

[Hypognosis]

//
237SJ
The real culprits are the drugs companies who hold peoples` lives to ransom.
//

Nailed it!

There is a possible way around this. The reason they charge so much is that the life of the product patent is remarkably short and the combined costs of primary research and - in particular - the double blind trial of a statistically significant sample size of what might be a very rare cancer condition means global-scale effort and enormous costs.

Lengthen the patent period to 50 or 100 years, to extend the time available to recoup those development costs but make this conditional on the company charging "affordable" rates to the NHS.

NHS does not individualise patient expenditure against their contributions history, thankfully. Nevertheless, £90,000 comfortably wipes out most people's lifetime contributions, doesn't it?

Also, the concept of "insurance" is one of spread risk, with few being so infortunate as to have to claim. There was a time when many would die without ever having a prolonged spell in hospital. These days, practically all of us will, either for cancer or extreme old age.

Reducing the service level would be inhuman. Increasing the 'premiums' (tax rates, to you) seems to be the only way to go. I am against privatisation in principle and I know that tax increases are a surefire way to lose an election, so this will never happen, in the age of spineless PR-driven politicians. :-[]

[gness]

Zacs.....my condolences also...xx

[Zacs-Master]

Thanks hypo & gness. Very kind and much appreciated.

It's rather stereotypical to pick best answer as one which concurs with my views, but Sqad's is the one which most closely matches my confusion.

[Svejk]

there's no simple answers. A 100 yr patent at affordable rates to the NHS might suit us. The rest of the world would take a dim view. And if the rest of the world used cheaper, generic drugs and we paid a premium price we wouldn't be happy.
Considering labs(Chinese?) can take any drug and reproduce it in hours, today, the world will have to come up with new methods of R&D etc. imo.

[black_cat51]

perhaps the research and development should be taken in-house, then the NHS can sell the drugs to the rest of the world. it must be profitable

[Hypognosis]

@svejk

Good point. Rumours abound that there are carbon copies of western car makes on China's roads, so we know they are no respecters of international patent law. The only protection would therefore be an export ban.

Which is all very well saying but, from past experience, many of the published research papers I saw in my uni days were peppered with Chinese or Japanese names. It is much more difficult to embargo the spread of scientific advancements. Even when possible, 'convergent thinking' means that someone somewhere will arrive at the same 'top secret' conclusion as you, within that extended patent window. :-/

@black_cat

You've heard of the "brain drain"? Two parts to that:
i) In the states they're big on 'freedom' and happily fund people to research where their personal interests take them. In Britain, we have a tight budget - airey fairey ideas get stamped on and ony things with a purpose that the civil servant holding the purse strings can understand and see practical uses for gets off the ground.
ii) Private sector (eg big pharma) pays so much more than the NHS ("public servants" and all the hoo-hah about salary and pension levels, remember?) ever could compete with.

Also, there's the liability issue. Profits have to be big enough to cope with another disaster on the same scale as thalidomide.