NHS decides a few extra months aren’t worth the cost

NHS decides a few extra months aren’t worth the cost

The UK’s National Health Service declined to offer colon cancer drugs Avastin and Erbitux to its patients. I read through the analysis done by the National Institute for Health and Clinical Excellence (NICE) and it seems reasonably balanced and systematic. Essentially, the conclusion is that the drugs produce statistically significant increases in survival rates, but the increase in life expectancy is only a few months and serious side effects can occur along the way. Meanwhile the cost is very high, and the NHS has more productive ways to spend its limited resources.

Some UK charities have criticized the government’s decision but have also said the companies should price the drugs lower –to reflect the actual benefit provided.

As I’ve said before, these sort of aggregate cost/benefit decisions are a real problem for pharma companies. They are blunt instruments that deny treatments to people who may be able to benefit. I’m hopeful that within a few years we’ll see diagnostics that predict who is likely to gain a major benefit from drugs like this, and that the NHS will pay for the diagnostic for everyone and treatment for those who will really gain.

Although analyses like these are not widespread yet in the US, the era of paying top dollar for marginal gains in oncology treatment is going to come to an end one way or another.

August 23, 2006

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