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By: Jeremy Laurance, Health Editor, The Independent
Friday, 8 August 2008
“Why are we asking this now?
Cancer charities, kidney specialists and campaigners were outraged yesterday when the National Institute for Clinical Excellence (Nice), announced that it had rejected four new drugs for advanced kidney cancer as too expensive for the NHS.
In draft guidance, the medicines watchdog said that the drugs can extend life by five to six months on average but they cost too much. The money would do more good if it were spent elsewhere in the NHS, it said.
Surely the NHS should provide these drugs?
Of course they should.
So why wouldn’t Nice give the go-ahead?
Because, it said, the drugs were not “cost-effective”.
What do the drugs cost?
Between £20,000 and £35,000 per patient per year. But that is only half the story. We also need to know how much benefit they bring.
Why are the drugs so expensive?
This is the question that dare not speak its name. It is incomprehensible that the manufacturers of the four drugs have so far escaped criticism. They are charging astronomical prices for drugs that offer little benefit – in effect, holding a gun to the heads of kidney cancer sufferers and saying to the NHS: “Give us the money or we shoot.”
So did Nice do the wrong thing?
* Patients in need of these drugs have few other options available to them
* Expensive or not, other European countries find the funds to provide the drugs
* It is inhumane to deny anyone the chance of living longer, even if the drug is not a cure
* They are too expensive for the benefit they deliver, which is not ultimately life-saving
* This is a zero-sum game: a pound spent on one patient is a pound denied to another
* It is unrealistic to expect every drug to be approved: the NHS budget is not unlimited
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