The issue of testing advances for efficacy and value in health care is one of the sticking points for our conservative friends. They oppose such testing and feel that everyone should have infinite choices, no matter the cost or limited efficacy. And Medicare and many other insurers should simply pay and pass through the additional costs. How else to interpret their criticism of comparison testing and evaluation of efficacy in the health reform bill–and the cost savings built into it.
There is however a voice of reason somewhere. (Financial Times November 7, 2010)
But the principle is justified: a centralised body is needed systematically to assess whether a drug offers therapeutic advantages and is cost-effective. Otherwise, in a health system with finite funding, such treatments will squeeze out others offering better outcomes.
In practice, Nice should be involved in establishing value too. Its role could be extended to rule on what constitutes a fair price at the time of launch with periodic amendments as greater clinical use better demonstrates value.
Medicynical note: Of course in the U.S. we don’t have finite funding. We think it’s perfectly all right to spend twice as much as other industrialized countries per capita on health care and eat up almost 20% of GDP. Value in medicine? An archaic concept when the profits of the medical industrial complex are involved.