Rationing by deliberate delay – how does this fit with the “core values”?

An announcement which may apply to England only (not the other three Regions?) is pre-released in The Guardian 15th March 2017. Delays in approval of proprietary products (value based pricing), until as near to patent expiry as possible, is just one method of rationing by delay, but it should be called what it is, and politicians should be quizzed by the media on their “core values”:

NHS patients could face wait to access life-saving drugs  – New rules mean health bosses in England can delay rollout of expensive treatments after approval by Nice

Patients could face delays accessing drugs on the NHS after health bosses agreed that the most expensive treatments can be stalled.

Even when a drug has been approved by the National Institute for Health and Care Excellence (Nice) – which already has strict rules on affordability – bosses at NHS England can now slow down its delivery to patients.

The move applies to any drugs that are expected to cost £20m or more in any of the first three years of their rollout across the NHS.

This could apply to cheaper drugs that will be used by hundreds of thousands of people or very expensive drugs used by a small number of people. Drugs used to treat a range of conditions, including diabetes or cancer, could be affected.

Under the move, NHS England can ask Nice to extend the amount of time the NHS has to bring the drug in for all patients – in some cases for three years. At present, the NHS has 90 days to make Nice-approved drugs available…..

…Other changes agreed by the Nice board include the introduction of a new fast-track option for treatments which cost less than £10,000 per year of good quality of life to patients.

The upper end of Nice’s standard threshold range is £20-30,000 per year. The new fast-tracking will mean cheaper treatments go through the appraisal process in six months rather than nine.


Rationed – Start of cheaper technique for breast cancer is delayed in UK despite adoption elsewhere. GP commissioners should be demanding intra-operative radiotherapy.

More money needed… lets pour a little more into the holed bucket – and reduce the quality of care by rationing new treatments

Fast-track plan cuts wait for newest drugs by years… will cost more in an unrationed service

Increasing the “Heath divide”? – Dementia victims to have drugs rationed. The “affordability test” is reasonable and sets a precedent at the high cost end..

Value Based Pricing: Drug prices guaranteed to bring headaches


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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