Wednesday, 10 September 2008

Drug watchdog NICE 'spends more on 'spin' than tests on new treatments'

I just happened to notice this, down at my local corner shop. I thought it was funny, and ironic, and sad, and piss-poor journalism, and probably some other stuff in roughly equal measure.

Drug watchdog NICE 'spends more on 'spin' than tests on new treatments'

Let's see, I didn't bother reading past the second para, but let's see what I can pick fault with:

1. NICE isn't the drugs' watchdog, in the UK. The Nine Elms Massive is. Nor is it concerned with rationing; it has a budget. It has a method, for assessing whether drugs grant sufficient benefit (in terms of improving/extending life), such that they should consume taxpayers' cash (bearing in mind that the NHS, which will be ultimately footing the bill, will be doing so with public money). Some may disagree with the criteria, but the alternative is to deal with everything on a case-by-case basis, which would cost even more money, because of the need to employ additional assessors, presumably, or else to routinely pass everything for use on the NHS, which would presumably suit the Worshipful Company right down to the ground.

And let us not forget that assessing drugs for use on the NHS is not the only thing that NICE does. It also drafts best practice guidelines for clinicians. Which clinicians ignore, if my experience is anything to go by. It drafts guidance for the administration of medicines. And it also looks at promoting good health and preventing illness. Now, I wonder how much these additional "cost buckets" represent, and, if added to the figure for drug assessment, would dwarf the "spin" expenses?

Oh, and given that the Worshipful Company spends, what, twice as much on S&M as it does on R&D, I think we ought to have a better understanding of why it is necessary to assess the value of drugs to the NHS as closely as is done, and where the real scandal lies, as the Worshipful Company recoups its overheads at the taxpayer's expense. Incidentally, I seem to remember that the ABPI was lobbying (and probably still is), for public cash to be spent on funding trials, mark you, trials, for drugs as yet unlicensed by the MHRA. It's a different subject, but the issue of secrecy rears it's head, here: does the public get to see what it paid for, in the event that such a mind-fuckingly grotesque scheme is followed?

Potentially, then, we have a scenario whereby the public pays for the Worshipful Company's products to be trialled; it never gets to see the results of the those trials, owing to "trade secrecy;" a product gets licensed as safe and efficacious by the MHRA; and NICE declines to pass it for use on the NHS. The upshot being that the Worshipful Company has had a large slice of its R&D covered by the public, who don't get to use the drug, the value of which is presumably debateable, if NICE didn't pass it.

2. WTF does "widely criticized" mean? The ABPI sure as hell doesn't like NICE very much, and for very obvious reasons, given that the NHS gives the Worshipful Company more cash than everybody else put together, in the UK. Patient groups, representing patients with particular illnesses/conditions are likely to be clamouring for any new drug available, if they perceive a solution lies in the administration of drugs. And individual patients are going to complain, because they're desperate. That doesn't look like a particularly "wide," let alone all-encompassing, sample of criticism.

...Oh, bollox! It's a fucking boring newspaper, anyway, but there's no excuse for that kind of half-arsed propoganda.


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