Word: nice
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Dates: during 2000-2009
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...NICE uses a metric called "quality-adjusted life year," or Qaly, which grades a person's health-related quality of life from 0 to 1. Say a new drug for a previously untreatable condition comes on the market and the drug is proven to improve a patient's quality of life from .5 to .7 on the scale. A patient on the drug can expect to live an average of 15 years following the treatment. Taking the new drug thus earns patients the equivalent of three quality-adjusted life years (15 years multiplied by the .2 gain in quality...
Taking its lead from Britain's Department of Transport - which has a cost- per-life-saved threshold for new road schemes of about $2.2 million per life, or around $45,000 per life year gained - NICE rarely approves a drug that costs more than $45,000 per Qaly (the fictitious drug would easily pass...
...only does the equation make hard-nosed sense in a public-health system, its use can reduce costs in other ways. Eager to gain NICE's approval, drug companies have started giving away portions of expensive treatment for free in Britain in order to ensure their drugs meet the threshold. Sir Michael Rawlins, chairman of NICE, believes that if the U.S. adopted a similar system, it would revolutionize the culture of major pharmaceutical companies, many of which spend more on marketing than research and development. A 2008 study in the New England Journal of Medicine predicted that incorporating information about...
...NICE approves over 90% of new drugs, and those it rejects are rarely life-saving. But it has turned down some expensive treatments that prolong life - most notoriously, the kidney cancer drug Sutent in 2008 - angering patients and oncologists. The organization has since promised to approve more expensive life-saving drugs for illnesses affecting fewer than 7,000 patients a year. Rawlins concedes that NICE is "muddling through" uncharted waters: "The biggest lesson we've learned is to be open and transparent. But you have to be willing to make difficult decisions...
Peter Pitts of the Center for Medicine in the Public Interest says higher prices are a risk America will have to take. "Because NICE is concerned about saving money and not what's in the best interest of the patient, its methods are not only imprudent, they are unethical," he says, arguing that pharmaceutical firms use profits to fund research and development. Rawlins has a different take. "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. That's a rather...