Even by NICE\’s own rules.
There\’s three drugs for rheumatoid arthritis. No one knows which one a patient will respond to. So currently they try the three out and see what works. (I simplify of course). The new rules say:
The National Institute for Health and Clinical Excellence (Nice), today issues a final appraisal document – the last draft before definitive guidance is issued – stating that patients who do not respond to one powerful drug cannot try another of the same type.
Currently doctors are able to try patients on three variants of a drug type which work by blocking the action of a chemical.
If one does not work or its effectiveness wears out over time, sufferers can switch to another, prolonging the period they can remain fit and active.
But the drugs are very expensive, with even the cheapest costing around £100 a week per patient.
Now ra can be crippling, and even when it isn\’t, extremely painful. The NICE rules are that (roughly) the NHS will pay for treatments that cost less than £50,000 per quality adjusted year of life.
To deny drugs for ra costing £5k a year means that they are assuming that the disability of ra is 10% or less or the value o life itself…..which, given that people can be entirely incapable of work as a result, seems incredibly low.
There\’s something odd about this decision.
There\’s some 20,000 people who have so far switched such drugs, so that\’s the number this will affect. A savings of perhaps £100 million per year
To leave 20,000 people in severe and debilitating paid for perhaps decades?
One thousandth of the current health budget. a rounding error in government finances.
Doesn\’t sound quite right to me really.