Life is cheap in Britain's NHS, but not cheap enough for Alan Maynard a health economist and Chairman of York Hospital in the UK who was recently bestowed the title Officer of the British Empire (OBE) for his services to the NHS.
Here's Sir Alan's most recent contribution:
Time for NICE to lower its cut-off price?
A leading health economist has suggested that NICE’s new year’s resolutions should include lowering the cut-off threshold for new drugs from £30,000 per quality adjusted life year gained to £20,000.
Professor Alan Maynard’s suggestion comes in the wake of the recent re-announcement of the Government’s response to the Richards Review on drug top-ups, which has suggested that for end-of-life rarer conditions such as cancer, the cut-off threshold should be raised to £70,000 / QALY.
Professor Maynard, whose OBE was announced in the New Year Honours list, also points to findings from a House of Comons Health Select Committee report that the Scottish Medicines Consortium, which reviews new technologies within six months, has reached “remarkably similar conclusions” to those on NICE, and proposes that this duplication is wasteful.
Discriminating against those not near the end of life
Maynard also argues that the £70,000 threshold for people with rarer end-of-life illnesses represents “an arbitrary equity value judgment (which) is inherently unfair for those not in the last two years of life”.
He also emphasises that NICE has much work to do in removing from use existing technologies already adopted in the NHS that are not demonstrably cost-effective. Writing on Health Policy Insight, Maynard suggests that the current recession’s inevitable effect on NHS funding “requires NICE to pay much more attention to marginal technologies already being used in the NHS, as their elimination will free resources to provide better patient care”.
Maynard also suggests that NICE should work “much harder to acquire a price setting role” – a radical proposal, given the existing barrage of negative publicity NICE has faced over its refusals to approve products for NHS use.
Hmm. If 70,000 pounds is arbitrary, then so is 20,000. And so is the judgment that the recession's inevitable effect on NHS should lead NICE to use even older and cheaper technologies and ration new ones further. Sir Alan as a hospital administrator? I'd bring my own food if I had to go inpatient at York Hospital. Come to think of it, what are the mortality rates there?
The fact is, NHS has a 3 million pound surplus attained in the same way NICE and NHS have rationed technologies. At the same time rates of chronic illness are rising and death rates from cancer are the highest in the Western world.
And here in America, comparative effectiveness is being offered as a tool to solving the innovation "problem." In reality, comparative effectiveness is just an arbitrary judgment made by government about who should get what and when.
Read More
Here's Sir Alan's most recent contribution:
Time for NICE to lower its cut-off price?
A leading health economist has suggested that NICE’s new year’s resolutions should include lowering the cut-off threshold for new drugs from £30,000 per quality adjusted life year gained to £20,000.
Professor Alan Maynard’s suggestion comes in the wake of the recent re-announcement of the Government’s response to the Richards Review on drug top-ups, which has suggested that for end-of-life rarer conditions such as cancer, the cut-off threshold should be raised to £70,000 / QALY.
Professor Maynard, whose OBE was announced in the New Year Honours list, also points to findings from a House of Comons Health Select Committee report that the Scottish Medicines Consortium, which reviews new technologies within six months, has reached “remarkably similar conclusions” to those on NICE, and proposes that this duplication is wasteful.
Discriminating against those not near the end of life
Maynard also argues that the £70,000 threshold for people with rarer end-of-life illnesses represents “an arbitrary equity value judgment (which) is inherently unfair for those not in the last two years of life”.
He also emphasises that NICE has much work to do in removing from use existing technologies already adopted in the NHS that are not demonstrably cost-effective. Writing on Health Policy Insight, Maynard suggests that the current recession’s inevitable effect on NHS funding “requires NICE to pay much more attention to marginal technologies already being used in the NHS, as their elimination will free resources to provide better patient care”.
Maynard also suggests that NICE should work “much harder to acquire a price setting role” – a radical proposal, given the existing barrage of negative publicity NICE has faced over its refusals to approve products for NHS use.
Hmm. If 70,000 pounds is arbitrary, then so is 20,000. And so is the judgment that the recession's inevitable effect on NHS should lead NICE to use even older and cheaper technologies and ration new ones further. Sir Alan as a hospital administrator? I'd bring my own food if I had to go inpatient at York Hospital. Come to think of it, what are the mortality rates there?
The fact is, NHS has a 3 million pound surplus attained in the same way NICE and NHS have rationed technologies. At the same time rates of chronic illness are rising and death rates from cancer are the highest in the Western world.
And here in America, comparative effectiveness is being offered as a tool to solving the innovation "problem." In reality, comparative effectiveness is just an arbitrary judgment made by government about who should get what and when.
Read More
