Emma Warren

How much is your life worth? How much would you give to wake up tomorrow morning in good health, and continue to do so for the next year? Most of us would place a high price on our own and loved ones’ life and health.

However, each year NICE (National Institute for Health and Care Excellence) refuses funding for drugs which would improve and extend the lives of many patients, on a solely financial basis. NICE calculates QALYs (Quality Adjusted Life Years) for each new drug by weighting the quality of a person’s life aftertreatment, from 0 (death) to 1 (perfect health). If a treatment costs more than the threshold of £30k per QALY, NICE is likely to refuse the treatment being implemented within the NHS.

Many people would suggest this is not fair, stating that their life is surely worth more than that. (As an aside, if I were to be unfair to the NHS and NICE and perform a crude approximation, my life so far has been worth a maximum of £655,890…)

Despite this, all things must be considered in the context of the NHS as a whole. If a treatment for one patient group is recommended, another group will inevitably suffer due to re-allocation of resources. This is not to deny the pain and trauma that not having a drug will cause patients and their loved ones.

Imagine being elderly and in a hospice which is only affordable because treatment has been held back from a cancer patient.

Imagine being a mother whose child who can receive treatment for a disease because a terminally ill Grandmother has been denied the drug she needs.

Now imagine being the family of, or the patient who has been denied treatment. It’s heart-wrenching stuff.

£95,873M was the allocation to the NHS for 2013/14[1] which seems like huge amount of money, but however much or little it is, books must be balanced. Those on the NICE committee making the decisions about whether drugs should be recommended may appear to have cold hearts, but they have to see the bigger picture. One family needing a treatment for a loved one will have tunnel vision on that; anyone would. But the budget is set and there has to be a committee to delegate funds.

Unfortunately, those do not go where we might sometimes wish they would. Hopefully it is not impossible to see at least some of the bigger picture.

[1] National Health Service Commissioning Board Annual Report & Accounts 2013-14 (pg 21)

For a summary of NICE appraisal decisions, see https://www.nice.org.uk/news/nice-statistics