[OT] British Balance Benefit vs. Cost of Latest Drugs

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December 3, 2008

British Balance Benefit vs. Cost of Latest Drugs

By GARDINER HARRIS

RUISLIP, England - When Bruce Hardy's kidney cancer spread to his lung, his

doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British,

and the British health authorities refused to buy the medicine. His wife has

been distraught.

" Everybody should be allowed to have as much life as they can, " Joy Hardy said

in the couple's modest home outside London.

If the Hardys lived in the United States or just about any European country

other than Britain, Mr. Hardy would most likely get the drug, although he might

have to pay part of the cost. A clinical trial showed that the pill, called

Sutent, delays cancer progression for six months at an estimated treatment cost

of $54,000.

But at that price, Mr. Hardy's life is not worth prolonging, according to a

British government agency, the National Institute for Health and Clinical

Excellence. The institute, known as NICE, has decided that Britain, except in

rare cases, can afford only £15,000, or about $22,750, to save six months of a

citizen's life.

British authorities, after a storm of protest, are reconsidering their decision

on the cancer drug and others.

For years, Britain was almost alone in using evidence of cost-effectiveness to

decide what to pay for. But skyrocketing prices for drugs and medical devices

have led a growing number of countries to ask the hardest of questions: How much

is life worth? For many, NICE has the answer.

Top health officials in Austria, Brazil, Colombia and Thailand said in

interviews that NICE now strongly influences their policies.

" All the middle-income countries - in Eastern Europe, Central and South America,

the Middle East and all over Asia - are aware of NICE and are thinking about

setting up something similar, " said Dr. s Seiter, a senior health

specialist at the World Bank.

Even in the United States, rising costs have led some in Congress to propose an

institute that would compare the effectiveness of new medical technologies,

although the proposals so far would not allow for price considerations. At the

present rate of growth, medical costs will increase to 25 percent of the

nation's gross domestic product in 2025 from 16 percent, with half of the

increase coming from new drugs and devices, according to the Congressional

Budget Office.

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