Yesterday the UK’s National Institute for Health and Clinical Excellence (NICE) concluded that £35,000 a year (about US$70,000) for new drugs that have been proven to have efficacy in the management of advanced renal cell carcinoma (kidney cancer) is more than the National Health Service (NHS) can afford.
According to a report in The Times NICE has:
concluded that the money would be better spent elsewhere in the NHS, where it would do more good. The decision to issue draft guidance rejecting Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) has outraged charities, kidney specialists and campaigners. It leaves patients with only one treatment option, interferon, to which many do not respond.
The way in which NICE goes about making its decisions about what the NHS can and can’t afford to pay for seems to be becoming an increasing problem. Health + Strategy appreciates that, as a society, we are going to have to “deal with” the fact that drugs that are used to treat small numbers of patients are costly to develop. However, it also needs to be understood that the decisions being made by NICE would appear to be in direct conflict with the aims of the medical community to treat patients to the best of their ability.
The differing communities of opinion appear to be talking straight past each other, and if there is a “good neighbor” who is seeking to find some common ground and some common language between these communities his/her activities are somewhat less than apparent.
Health + Strategy would like to be able to say that we have five absolutely brilliant solutions to this issue. Alas, we would be deluding ourselves to even think we had one. However, this cost/value balance is going to become ever more critical as we move into a world of personalized medicine. It is almost a self-evident truth that a broad solution to this problem is essential. And it will require real cooperation from all the players with a stake in the game.
The first requirement is going to be some inspired leadership, either from the biopharmaceutical industry or from the “payer” community, that can bring everyone to the table with a willingness to find solutions. While there is a political element to this problem, politicians will never find an acceptable solution, only a compromise.
By contrast, the payers and the drug manufacturers should both be able to look at this situation with the understanding that they have a real responsibility to patients to ensure access to effective drugs. In the case of kidney cancer, we now have a situation in the UK where the state will pay for a drug (interferon) that has minimal effectiveness for a subset of patients but will not pay for even one of the four drugs that seems to offer a quantum leap in effectiveness.
Something is rotten in the state of our health!
Filed under: Business strategy, Drug approvals and regulation, Health and drug costs, health economics | Tagged: Add new tag, cancer, cost, economics, kidney, NICE
