Guidance 'will not improve' availability of costly drugs
New Nice guidance unlikely to improve availability of expensive drugs
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Tuesday, 13, Jan 2009 12:32
New guidelines aimed at improving access to expensive end of life drugs for terminally ill patients are unlikely to have much of an impact, a report claims.
A study published on BMJ online today suggests the new National Institute for Health and Clinical Excellence (Nice) guidelines are unlikely to lead to the acceptance of all the drugs provisionally refused.
Between 1999 and 2008 Nice rejected 11 drugs on the grounds of cost effectiveness, sparking ethical, legal and political controversy.
The fallout led to a review which suggested Nice should revise its cost threshold for end of life drugs.
The new advice applies to treatments that affect small numbers of patients who are not expected to live more than 24 months, and that offer demonstrable survival benefits (at least an extra three months of life) compared with current NHS practice.
For his study, Professor James Raftery, from Southampton University, examined the effect the new arrangements would have had on all cancer drugs that Nice has refused or proposed to refuse because of cost effectiveness.
The professor found that only a few of the rejected drugs would qualify under the new criteria, with most failing to meet the criterion that no alternative treatment with comparable benefits existed.
He added that making an exception for any group would set a precedent for other groups, and that setting the threshold higher for some groups within a fixed overall budget results in other patient groups being denied treatment.