People Power ! NICE orders a review of NHS funding limit for newdrugs as it bows to public pressure. ;!

It is not as if all this is a free-bee from the "government." the
"government " has only those monies that come from the people.....

NHS drugs body Nice reviews drug funding
The NHS drugs rationing body has ordered a review of its funding limit
for new drugs after a series of campaigns by patients groups denied
access to treatment.


By Rebecca Smith, Medical Editor
Last Updated: 10:46AM BST 30 Aug 2008

Comments 8 | Comment on this article
NICE orders a review of NHS funding limit for new drugs as it bows to
public pressure. ; http://link.brightcove.com/services/...ctid1761979127
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The National Institute for health and Clinical Excellence (Nice) has
commissioned research to establish whether the threshold at which
drugs are determined to be cost effective is set too low.

It has not changed since Nice was set up nine years ago even thought
the NHS budget has more than doubled in that time and there has been
no adjustment for inflation in that time.

The results of the review will be discussed early next year and could
pave the way for more expensive drugs being made available on the NHS.

Campaigners may see the move to consider raising the threshold as a
tacit admission that it is currently too low.

The organisation has faced a storm of protest over its refusal to
recommend the use of a string of drugs for use in the NHS including
treatments for Alzheimer's, arthritis, eyesight conditions and cancer.

Earlier this week kidney cancer patients and their carers demonstrated
outside the headquarters of Nice after draft guidance on four new
drugs to treat late stage cancer were

turned down even though they extend life on average by four to five
months.

NICE also apologised over the fact that it took more than two years to
issue final guidance approving the eyesight-saving drug Lucentis after
previously ruling that patients would have to go blind in one eye
before receiving the drug

Figures showing that the NHS is expected to have a surplus of £1.75bn
this financial year sparked further concerns about funding for
treatments.

The Citizens Council of Nice, a representative sample of 30 members of
the public, examined the calculations earlier this year and
recommended "a thoughtful and penetrating review".

Nice's method involves quality of life scores which one Citizens
Council member found would give her a negative score meaning she would
be 'better off dead' as she is confined to a wheelchair, a report of
the meeting said.

The quality of life score forms part of the calculations used to
determine the extra Quality Adjusted Life Years (QALY) that a new drug
would give patients balanced against the extra cost.

Each QALY is the equivalent of one year of perfect health, two years
of 50 per cent perfect health or four years of 25 per cent perfect
health.

Nice has set the acceptable cost per QALY at between £20,000 and
£30,000.

The more expensive a drug is the more it has to improve and/or extend
life in order to meet the threshold. In exceptional cases more
expensive drugs that breach the upper limit have been recommended.

The calculations pay no regard to the NHS budget in any way.

Pat Hanlon, trustee of the campaign group Kidney Cancer UK, said: "We
think the QALY is woefully inadequate as a measure of patient benefit.
It was arbitrarily set and we think it is too low.

"It will be very difficult for any new cancer drug to pass the test
because they have very high research and development costs. And with
the kidney cancer drugs there is a relatively small number of patients
so the cost per patients to recover the R&D costs are fairly high."

Prof Karol Sikora, Medical Director of CancerPartnersUK, Professor of
Cancer Medicine at Imperial College School of Medicine, said a review
of the QALY was 'long overdue' because the European threshold stands
at around £45,000.

He added: "It is absolutely essential that some allowance is made for
the increase in the NHS budget and the fact the medical inflation is
running at about 10 per cent a year at the moment."

Argument has raged between academics and experts on whether the QALY
it set correctly since Nice was launched in 1999, with some saying the
threshold should lower so drugs would have to be cheaper or more
effective to get through, while others believe it must be higher in
order to take into account more sophisticated and expensive drugs that
are in development.

Richard Davidson, director of policy and public affairs at Cancer
Research UK, said of the threshold: "We believe it is too low in the
context of other areas of government expenditure, and in comparison to
the amount of money spent on new drugs by our European counterparts.
"Additionally, it does not take into account inflation since the
threshold was first used."

A NICE spokesperson said: "We have commissioned research to assess
whether our current threshold range is reasonable or whether it should
be altered; and the findings will be discussed, fully, at a workshop
next January."