NHSreality is content that Nivolumab (Bristol-Myers Squibb) is not yet approved for the UK Health Services by NICE. NHSreality is not happy that it is covertly rationed, and that some people will be covered for it either by their wealth, or by Private Medical Insurance. The Drug Data sheet is complicated but clear. Survival at 12 months is improved, and the relative chance of being alive compared with no treatment at 12 months is 3 fold. However the absolute chance of survival is low… and it looks very much as if it merely delays the inevitable, and with a low quality of life.
Despite the cost of over £100,000 per annum it has been approved for some conditions. Giles Sheldrick and Olivia Lerche report in The Express 7th December 2016: Blood cancer breakthrough: New immunotherapy treatment nivolumab approved for use (In lymphoma). This is good news. However, if we are going to ration health at the expensive (fearful because none of us can afford it) pole, we need to do it overtly rather than covertly. My personal preference would be the ration high volume low cost treatments, and be able to afford the new technologies, but still feel that there is “Too much chemotherapy”…. This is an area where the greatest savings and improvement in quality of life could be made.
A A Gill rightly exposes the covert rationing he was unaware of – until he became ill.. But proper end of life care would be better value..