Treatment Choices

The decision by NICE that the cancer drugs bevacizumab, sorafenib, sunitinib and temsirolimus do not offer value for money (BBC story) has attracted a lot of coverage today, and the usual collection of critics have surfaced to attack the decision.

There have been lots of people saying that all treatments should be available, free of charge (presumeably they would allow the prescription charge regime to apply) to everyone, regardless of cost. This is of course utterly impractical.

Every day new treatmets are discovered, but these discoveries are the result of long and costly research. The drug companies need to recover the costs of this, so the treatments are necessarily costly. Whoever said that an AIDS pill may only cost cents but the first one cost billions was on the mark.

There is only a finite amount of money available, and healthcare is not the only responsibility of government, so we are left with a dose of reality. If the NHS makes all treatments available to all patients, regardless of cost, then we would end up in a situation where you would be fine if you fell ill in April or May, but would otherwise have to wait until there was more money available to treat you.

This issue, and it is by no means the first time it has arisen, demonstrates why it is in practice impossible to have universal healthcare, free at the point of access, from cradle to grave. Healthcare provision will always be a matter of balancing cost with provided coverage. If this lesson were learned, we could perhaps move to a more liberal system whereby the state concerned itself with only the most basic matters and with emergency provision, allowing people to keep a little more of their hard earned money, with which to decide what level of provision they wished to take out to supplement this.