“But its an effective treatment, you MUST pay for it”. Five considerations

“But its an effective treatment, it will change lives, you MUST advocate that we have access to it”. 

I was told by a ortho colleague of mine last year in regard to a treatment prior to a NICE TA (NICE eventually said no)

We had a very interesting discussion following this, focused on 5 questions 
1. Do you believe that NHS is cash limited

Yes of course.
2. Do you think there should be objective evidence that benefit outweigh harm prior to introduction

Yes of course
3. Do you believe that should be objective evidence re cost effective prior to intro

Yes but sometimes we do things before we know about cost effectiveness

This spares people from more invasive treatments, thus it must be right thing to do

Square that with 1. & 2. ?
4. As there’s no more cash – Are you okay that others will be denied care if the evidence suggests that the introduction of the treatment is a net cost for the NHS

Hmmm, less so
5. Can you identify which group you’d like to deny the care of

 Oh but that’s the commissioners job isn’t it…..

Back to 1. 

It changed the nature of the conversation. 



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