In our post-SiCKO, sound-bite-centered politically-charged environment, we’re hearing a lot about the “wonders” of “European-style” healthcare models.
Well, if we’re going to look at Europe – let’s really look. And let’s start with some recent news from London.
Late last week consumer group campaigners won a landmark victory in the fight to overturn a ban on Alzheimer's drugs for tens of thousands of patients.
The Court of Appeal in London said that NICE (the National Institute for Health and Clinical Excellence) the agency that evaluates the cost-effectiveness of drugs -- had acted unfairly by not fully disclosing how it evaluated Alzheimer's drugs.
In 2006, NICE ruled that drugs such as Aricept, Reminyl and Exelon don't benefit some patients enough to be worth their cost and recommended that the state health service pay for the drugs only in patients with moderate rather than mild Alzheimer's disease.
The Court of Appeal decided the process used by the Government's rationing body to ban use of the drugs - which cost only £2.50 a day - was unfair.
The case could pave the way for the drugs to be re-instated for newly diagnosed patients with 'mild' symptoms of the disease.
The three judges yesterday ruled NICE must release a full version of the economic model which it used to produce the guidance restricting access to the drugs.
By refusing to do so, NICE had put those taking part in consultation - including the Alzheimer's Society - at a significant disadvantage in challenging its reliability.
Experts said the ruling could have wider implications because it showed a key part of NICE's work is secretive, undermining confidence in guidance that has led to other drugs being rationed.
Dr Susan Benbow, former chairman of the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists, said: "The next stage should be to overturn the guidance which was not only reached during an unfair process, but is inequitable on grounds of human justice to patients who should have access to these drugs."
The cost of prescribing the drugs to a patient with the early symptoms of Alzheimer's is £2.50 a day, or around £1,000 a year - but the potential savings to taxpayers and families are huge.
Studies show that full-time care for an Alzheimer's patient is £25,000 a year, or around £520 a week.
But the National Institute for Health and Clinical Excellence used a much lower figure of £18,500 - less than £369 a week - for the costs of full-time care when calculating whether the NHS could afford to fund treatment with the drugs.
For some sobering American pharmaco-economic data, have a look at the CMPI report, “Alzheimer’s Disease and Cost-effectiveness Analyses: Ensuring Good Value for Money?
Professor David Wilkinson, a leading old-age psychiatrist, said: "These drugs can stabilise patients for two or three years and it's perfectly possible for those who respond to gain six months or a year living at home.
Professor Wilkinson said that under the ban, some newly diagnosed patients were being told by their doctor to come back in six months' time, by when their symptoms would have got worse and they would be eligible for treatment.
"Doctors have been put in an impossible position - it goes against everything in our medical training,' he added.
If we’re going to look to Europe – then let’s really look. And if we’re going to talk about comparative effectiveness – let’s really talk.
