NICE Breaker?

The United Kingdom’s National Institute for Health and Clinical Excellence (NICE) has reversed it’s earlier decision to deny payment for (sunitinib malate) and will pay for it as a first-line treatment for patients with metastatic renal cell carcinoma mRCC (advanced kidney cancer). 

According to NICE, “Sutent provided a step-change in the first-line treatment of advanced and/or metastatic RCC and [NICE] noted that more than 20% of the public and patients that responded in consultation highlighted this impressive benefit from sunitinib.”

(More than 7,000 people are diagnosed with kidney cancer in the UK each year and approximately 3,600 people die from the disease.)

This reversal is effectively an acknowledgment that the agency hasn’t worked as intended.
 
And just what caused the the reversal?  Why evidence, of course.

A spokeswoman for NICE said the organization was reevaluating Sutent because "there was more evidence submitted during a couple of periods of the appraisal process by manufacturers, which needs to be discussed by the [appraisal] committee.”

Couldn't have been anything else, right? Well, according to a report in The Guardian,

“The move follows British Health Secretary Alan Johnson's decision this month to overhaul the way new medicines are assessed for terminally ill patients. Denying cancer patients access to drugs that are widely available abroad has become a major political issue."

Here's what NICE Chairman, Sir Michael Rawlins had to say, "We must be fair to all the patients in the National Health Service, not just the patients with macular degeneration or breast cancer or renal cancer. If we spend a lot of money on a few patients, we have less money to spend on everyone else. We are not trying to be unkind or cruel. We are trying to look after everybody."

As Robert Jones (a retired Glaxo Wellcome executive and former member of EFPIA's economic policy committee from 1994 to 2006, and its chairman from 1994 to 2001) writes:

“At the root of NICE’s operations is a Benthamite approach to health benefits. For NICE, value equates to social utility, the optimisation of which informs all of its judgments. Some of NICE's decisions may seem cruel in human terms, and ill-advised in public relations terms, but there is an arid logic to them which can usually be seen at work.”

Utilitarianism isn’t a one-dimensional worldview.  Consider Bentham’s comment that,

“It is vain to talk of the interest of the community, without understanding what is the interest of the individual.”

Is the Sutent decision a NICE breaker?