Thursday, December 04, 2008

Not so NICE

Fantastic article on NICE, the UK agency that determines whether a given medical treatment is worth its price or not.
A clinical trial showed that the pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000.

But at that price, Mr. Hardy’s life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen’s life.
But this makes no sense:
Britain’s National Health Service provides 95 percent of the nation’s care from an annual budget, so paying for costly treatments means less money for, say, sick children. Before NICE, hospitals and clinics often came to different decisions about which drugs to buy, creating geographic disparities in care that led to outrage. (Such disparities are common in the United States, even for federal Medicare patients.)
Sick children provide excellent return on investment for treatments. A positive intervention in a child can yield years of benefits. Why don't children always win?
After consulting a citizens group, the institute decided that the nation should spend the same amount saving or improving the life of a 75-year-old smoker as it would a 5-year-old.
Ah, that makes sense. It is also highly informative about the value of consulting citizens' groups.


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