There is absolutely no objectivity in the reporting, and they use case stories of patients to publicise this. This is referred to in parts of the health system as 'shroud-waving'.
I find this whole situation somewhat disturbing, for two reasons - firstly, here was an objective method for determining the value of new medication, and secondly it is likely to result in the drugs bill becoming hugely inflated, as clinicians will face huge pressure to prescribe drugs that are marginal, unproven or enormously expensive. I will face that pressure, and will feel the need to prescribe for my patients.
It was actually the one role of NICE that the Jobbing Doctor took notice of.
The Government say that they are likely to negotiate a formula directly with the pharmaceutical companies, and that will be effective. I doubt this very much indeed.
I don't suppose the media will now be full of stories about hip replacements in the elderly being deferred because of new cancer treatments eating up the finite resources we have for health.
And if NICE aren't doing this any more, is there any need for this rather unnecessary and nannying organisation?
6 comments:
Dear JD,
I completely agree, the only useful function of NICE was to adjudicate on cost effectiveness. If they are not to do this then surely they should be on the bonfire of Quangos?
I think this is because of the coming wave of expensive, and effective biological drugs. The government escapes the blame when these are not funded. The British press and public hate "the postcode lottery" but this is implicit in local commisioning. Local commissioning requires variation between providers and commissioners in what they provide. To some extent this is reasonable, Eastbourne may want to provide alzheimers therapies over paediatric care for example.
Interesting times!
Glad you had a good break in Edinburgh, one of my favourite British cities also.
Dr Phil
I agree too. This is about the government shirking its responsibilities in this area. They want the blame for reasonable decisions on cost effectivenes to be put onto those who are going to be put in charge of the bulk of NHS spending. No wonder it worries you JD. This is what we thought would happen. GPs and not the government will have to take the blame for our not being able to afford absolutely everything. You will no longer be on the side of the patient but on the side of the rationers. Rationing of healthcare is something the government should have been brave enough to take on centrally and not tried to devolve in this way. GPs could then have been left as the patient's advocate.
It was recognised that NICE was leading the world on this. What a terrible shame.
"the only useful function of NICE was to adjudicate on cost effectiveness."
... and is 'the' model considered most successful by other countries including the US, who are looking at it's function with view to perhaps implementing same along similar lines.
Then again, why do you need Nice if you are a GP strapped for cash and need to make billions in effeciency savings too? You simply won't prescribe the expensive drugs, full stop ... problem sorted! - only astute patients who have the know how will get the expensive drugs ... how many of those around and where do they stand on the social ladder?
On the other hand, as a former manager in an acute trust, all Nice seemed to me to do was to delay the prescription of new cancer drugs by many months. I suppose there are always swings and roundabouts.
So this is the poison chalice to GP consortias,
Your GP will be the one to blame when your denied the drugs you need.
As a patient I have found the treatment guidelines (in particular those on pregnancy and birth) produced by NICE extremely useful.
I don't envy a GP telling their patient that drug X is not available because they have run out of money for the year or they have prioritized other cancer treatments or whatever.
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