In November 2008, the NICE Citizens Council met to discuss whether there were circumstances in which NICE should recommend treatments that we would not normally consider to be cost effective. The resulting report was presented to the NICE Board at its meeting in Belfast on 22 May. When deciding whether a treatment is cost effective, NICE’s independent Appraisal Committee and other advisory bodies use a measure called a QALY (quality-adjusted life year). If a treatment costs more than £30,000 per (about$49,500 US dollars) QALY gained, it is not normally recommended for use in the NHS (see reference below).

Well, this is the type of commission (no doubt headed by another czar) that the Congress and apparently the President wish to place in control of decisions regarding health care options and choices.  Under these NICE guidelines in England, it is very difficult to see how Senator Edward Kennedy would have received any treatment at all beyond pain management as his care clearly cost well, well in excess of the current NHS/NICE threshold of just under $50,000 dollars US per year.  So what would happen? Perhaps what has happened to many in England who are clamoring for access to other forms of treatment for kidney cancers that have failed to respond to traditional measures.  You would be denied access, unless you have the freedom to choose to go where you wish and pay what is needed to get the other treatments.  Is this on the basis of economics . . . yes, it is.  We live in a market based capitalist economy and that has served us well versus the rest of the world for almost three centuries.  Is it fair?  Yes.  The basis of our system rests on the ability of the individual to succeed and in the end take care of his self interest and that of those closest to him – family and friends.  We have offered many serious proposals to enhance health insurance coverage and therefore health care access without resorting to what can only be described as socialistic approaches (don’t be fooled by the new use of the word progressive; liberal=progressive=socialist).  We can have meaningful reform without a federal takeover of 1/6th of the economy.  A takeover which will forever dominate the social landscape of our nation.  We can do better than that in America . . . obi jo and jomaxx

Thousands of kidney cancer patients are likely to lose out on life-prolonging drugs

The NHS rationing body, NICE, has confirmed a ban on three out of four new treatments.  It has reversed its position on just one, Sutent, which will now be allowed for patients with advanced cancer. But campaigners who fought NICE’s original blanket ban said this was not enough. They said some patients with heart problems cannot tolerate Sutent. Kate Spall, head of the Pamela Northcott Fund campaign group, said the ruling meant that fewer than half of newly diagnosed patients would be eligible for therapy. She added: ‘Families will be denied time together and doctors will be unable to give patients the best treatment.’ Campaigners are angry that NICE appears to have ignored new official guidelines widening access to life-prolonging drugs. Sutent, also known as sunitinib, can double the life expectancy of patients, to 28 months, compared with standard interferon treatment. It costs around £24,000 a year.

The rejected drugs – bevacizumab (Avastin), sorafenib (Nexavar) and temsirolimus (Torisel) – have similar costs and are used in other countries. Nicole Farmer, of Bayer Schering Pharma Oncology, which makes Nexavar, said: ‘This shows why the UK sits 16 out of 18 EU countries with regard to cancer outcomes’.

Dr Thomas Powles, Clinical Senior Lecturer, at Barts and The London NHS Trust, said the ‘one size fits all’ policy would disadvantage many of the 7,000 patients diagnosed each year with kidney cancer.  He said: ‘This one dimensional approach will leave some patients without potentially beneficial treatments, indeed some patients will not be eligible for any effective treatments whatsoever.’

Stella Pendleton, executive director of the Rarer Cancers Forum, said: ‘This decision contradicts the spirit of the recommendations made by Professor Mike Richards on improving access to medicines for NHS patients, and highlights flaws in the current system for appraising drugs. ‘We call on Nice to reverse this decision.’

Kidney cancer patients denied life-saving drugs by NHS rationing body NICE by staff writer, April 29, 2009 Daily Mail (UK)

Kidney cancer patients denied life-saving drugs by NHS rationing body NICE – http://www.dailymail.co.uk/health/article-1174592/Kidney-cancer-patients-denied-life-saving-drugs-NHS-rationing-body-NICE.html

National Institute for Health & Clinical Excellence – http://www.nice.org.uk/

Citizens Council report on departing from the threshold – http://www.nice.org.uk/newsroom/features/CitizensCouncilReport.jsp

With quality treatment, Kennedy fought hard and long – http://www.boston.com/news/local/massachusetts/articles/2009/08/26/fighting_hard_fighting_long/

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