Home / Blog / Article


October 21 2009

Sorry, Too Expensive

Nicole Kurokawa Neily

One of the little-discussed provisions of the government's health care plan expands the use of comparative effectiveness research to determine the best treatment options for sick Americans. At first glance, that seems perfectly harmless - a panel of doctors, looking at research, and recommending what care patients should receive in particular circumstances.

Unfortunately, the reality is far more sinister. In Britain, their comparative effectiveness board, the National Institute on Clinical Effectiveness, has morphed from its benign purpose of monitoring treatments' effectiveness to a de-facto rationing board based on costs.

From the Daily Mail:

Lapatinib can halve the speed of growth of breast cancer in one in five women with an aggressive form of the disease.

It could potentially help about 2,000 women a year with HER2 positive cancer who have run out of options, including the wonder drug Herceptin.

But NICE says the NHS cannot afford the cost at £1,600 a month for each patient and lapatinib, also known as Tyverb, should be used only in clinical trials.

The drug maker GlaxoSmithKline (GSK) is giving the first three months of treatment free, with the NHS picking up the bill for those who respond and need it for longer.

Cancer tsar Dr Mike Richards last year said he hoped to see more such schemes on the NHS, but the move made no difference to calculations on the drug's cost-effectiveness made by NICE. ...

NICE deputy chief executive Dr Gillian Leng said: 'The Appraisal Committee considered the updated economic evaluation presented by the manufacturer but was not persuaded that the adjusted estimates of overall survival presented were robust. The committee therefore concluded lapatinib is not a cost-effective use of NHS resources.'

Cost-benefit analysis hasn't been written into the Federal Coordinating Council for Comparative Effectiveness Research's mandate yet - but as health care costs rise in the future inevitably (as more people demand more services from their government-run plans), it will almost certainly end up in there, just like it did in Britain. In "Is the Government Importing Rationing from the UK," Conservatives for Patients' Rights warns about this looming threat.

If a treatment is expensive, you, your family, and your doctor should be able to decide if you want to spend the money for the treatment - not a bureaucrat.

Independent Women's Forum is an educational 501(c)(3) dedicated to developing and advancing policies that aren’t just well intended, but actually enhance people’s freedom, choices, and opportunities. IWF is the sister organization of the Independent Women’s Voice.​
Follow us