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...cowering below a giant circular pill inscribed with the word pharma. Amid the supplicants strides an impervious figure from Britain's National Institute for Health and Clinical Excellence (NICE) with a puzzled look on his face. Like the man in the cartoon, NICE head Rawlins doesn't see why drug companies should deserve any deference. His organization uses hard-nosed cost-effectiveness reviews to decide which treatments Britain's National Health Service (NHS) should pay for. A new drug doesn't just have to work to impress NICE, it has to offer value for money - and if it doesn...

Author: /time Magazine | Title: How Much Is a Year of Life Worth? | 3/27/2009 | See Source »

...NICE needed? Shouldn't you get the drugs you need when you are sick, regardless of cost? All health-care systems are facing the problem of finite resources and almost infinite demand. And all health-care systems have implicitly if not explicitly adopted some form of cost control. In the U.S. you do it by not providing health care to some people. We are best known [for looking] at a new drug, device or diagnostic technique to see whether the increment in the cost of that treatment is worth the increment in the health gain. (See pictures of health care...

Author: /time Magazine | Title: How Much Is a Year of Life Worth? | 3/27/2009 | See Source »

...seems like NICE is forcing pharmaceuticals to play ball by offering special discounts to Britain. How do you manage that? Our list price is used as a reference price in other countries, so drug companies believe that a no from NICE is damaging globally. So they set up what we call "patient-access schemes." Drug companies may either give away certain portions of treatment [such as the last few doses of a course] or reimburse the NHS for those patients who don't respond, which has the effect of reducing the price of the drug and lowering the cost...

Author: /time Magazine | Title: How Much Is a Year of Life Worth? | 3/27/2009 | See Source »

...with its massive health-care market, did the same, could it have a transformative effect on drug costs? I think it could. The companies won't like it in America. But yes, it could...

Author: /time Magazine | Title: How Much Is a Year of Life Worth? | 3/27/2009 | See Source »

...drug companies' arguments that doing so will destroy their research-and-development budgets? Drug development has become so expensive it's going to become unaffordable no matter what happens. A lot of the expense is a consequence of the drug-regulatory authorities, who pile on regulation after regulation, which makes getting a drug to market hugely expensive. But the expectations of investors have to be tempered as well. The 15-20% [growth] of some companies is not going to be possible in the future. A third of staff of some big pharmacy companies work in marketing, and many companies spend...

Author: /time Magazine | Title: How Much Is a Year of Life Worth? | 3/27/2009 | See Source »

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