Tuesday, 18 February 2014

Too old to get lifesaving drugs


Too old to get lifesaving drugs: Anger at plan to deny elderly treatment if you've had a 'fair innings'

Patients who have had a ‘fair innings’ could be denied life-saving drugs under proposed health reforms.

The plans would mean experts taking into account whether there is a ‘wider societal benefit’ to giving a patient crucial medicines.

The NHS rationing body, Nice, fears the Department of Health proposals could see younger people deemed a higher priority for drug treatments because they have more years ahead of them – potentially contributing more to the economy – than the elderly.

Controversial: The NHS rationing body, Nice, fears the Department of Health proposals could see younger people deemed a higher priority for drug treatments (file picture)

Doctors, MPs and campaigners last night condemned the plans as ‘barking mad’.

The move will also fuel fears that the elderly are receiving a worse deal from the health service than the young.

Cancer charities have already warned that ‘cruel restrictions’ mean older patients have been denied medical treatment, regardless of a proper assessment of their fitness levels and how likely they could benefit from treatment.

Sir Andrew Dillon, the head of the National Institute for Health and Care Excellence, said he was concerned about the new rules and feared they would lead to older patients being penalised in a ‘hard-nosed’ and ‘crude’ economic approach.

The reforms, which are being consulted on, would see new drugs assessed for the first time based partly on whether they would benefit society as a whole – not just the patient.

For example, a drug that helped people to live longer in an expensive care home, or on welfare, might have a ‘negative’ social value not outweighed by the benefit to the individual, because such patients take more from society than they can put back.

Sir Andrew said: ‘There are lots of people who adopt the fair-innings approach: “You’ve had 70 years of life – you’ve got to accept society is going to bias its investments in younger people.” There are people who subscribe to that, but it’s not something we feel comfortable with.’

He said an initial assessment by Nice suggested that accounting for ‘wider societal benefit’ would inevitably tilt funding away from the old because younger patients had more to gain from treatment and more to give back.

He added: ‘We’re really concerned that we don’t send out a message that we value life less when you’re 70 than when you’re 20.’

Ciarán Devane, chief executive of Macmillan Cancer Support, said: ‘The UK has some of the worst cancer survival rates in Europe and they are especially bad for older people. Macmillan strongly recommends against any action which could make this worse. The Nice board is right to reject the Department of Health’s proposal.’

Penny Mordaunt, Tory MP and co-chairman of the all-party parliamentary group on ageing and older people, said any new rules on societal benefit would be ‘absolutely wrong’.
‘Age shouldn’t come into it,’ she said. ‘It’s about you as an individual and what drugs work for you. You cannot decide from someone’s age, their ability to benefit from treatment. It’s about them as an individual.’

QUALITY OF LIFE VERSUS THE COST

Under the current system, Nice determines the cost of a new treatment by working out how much it improves and extends a person’s life compared to existing treatments.

It uses a formula known as ‘quality adjusted life year’ or QALY.

One QALY equals one year of perfect health, or two years of 50 per cent perfect health or four years of 25 per cent perfect health.

Generally, if the cost per QALY is below £20,000, the treatment is deemed cost effective and approved.

If it falls between £20,000 and £30,000, Nice needs ‘persuasion’ to give it the go-ahead.

If the cost is more than £30,000, the drug is not normally approved.

Andrew Percy, a Tory member of the health select committee, said: ‘I am sure that [restricting drugs to older people] is not the intention of the rules. If it is, it would be barking mad. Clearly people who have paid into the NHS should receive the support they need through their entire lives, including in retirement.’Ros Altmann, a former adviser to the Treasury on older people, said it was ‘very frightening’ that such a model was being considered.

‘It is quite Orwellian that it is being said that if you’re no longer fit for work, you aren’t owed anything by society,’ she said.

‘It is wrong to say older people do not contribute to society. They do so much voluntarily for their local community and for their families through free childcare for grandchildren. All this saves us billions of pounds.’

Leading prostate cancer specialist Professor Jonathan Waxman said Nice was an organisation ‘not fit for purpose’.
He added: ‘Nice has been the main brake on the availability of cancer drugs during the last decade and caused considerable distress and deaths based on an opaque and unscientific evaluation system.

‘We need transparency about how these decisions are made.’

A spokesman for the Department of Health said changing the rules would ensure good value for money – without penalising the elderly.

He added: ‘That’s why we have asked Nice to look at the way drugs are assessed so that patients can get the treatments they need at the best value for the NHS.
‘The allegation that older people will miss out is absolutely not true.’

 

After reading this I am left feeling sick that any Government could even consider this, especially when they claim to be squeaky clean and are still fiddling expenses

 

There are many ways of raising money, including making sure that everyone in this country pays their tax’s, or should we say pays them to the treasury in the UK,  something the Tories have refused to do, yet it would raise billions of pounds.

  

Like so many other people I will never ever vote for this shower ever again, when I look at them carefully they are no better that the mafia.

Last night they showed a selection of medication on Television including Exelon, something I take for dementia with lewy bodies

  

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