How the NHS can deal with soaring drugs prices National Institute of Clinical Excellence decisions have sparked debate over funding the spiraling cost of medication
Last week the National Institute of Clinical Excellence (Nice) ruled that offering abiraterone, demonstrated to extend life by up to four months in advanced prostate cancer,
was not cost effective as a treatment when given before chemotherapy. Described as a
kick in the teeth by Prostate Cancer UK, the decision comes after
a similar Nice ruling the week before on kadcyla, shown to prolong life for a certain group of breast cancer patients. Blockbuster drugs with ever increasing benefit are expensive, and there are lots on the way.
To allow room for financing such drugs, first, doctors need to get back to the principle of prescribing drugs from the current arsenal of pharmaceuticals that they can be confident will offer benefit. A study from University College London and Public Health England suggests that inappropriate antibiotic prescriptions for viral coughs and colds is on the rise, raising the spectre of resistant strains of bacteria. For such common ailments, simple bed rest is often the best prescription. The lengthy appointment and explanation needed to justify the absence of a prescription requires time that todays NHS doctors have less of. All too often, I fear, a prescription playing on the dogma of taking a medicine being a solution to an ailment, is just easier.A far more sinister trend, leading to doctors switching to newer, more expensive drugs over older, cheaper ones, is a growing feeling that in some cases we are being misled by drug manufacturers. To make the right choices for their patients, doctors need to be able to trust the evidence of patient benefit. Randomised controlled trials, considered the gold standard for testing the efficacy of a new drug against conventional treatment or placebo, are expensive and time consuming to run, requiring extensive drug manufacturer sponsorship to coordinate results across continents and thousands of patients.
Continue reading... The Guardian
