Editor’s blog Tuesday 24 August 2010: NICE and price

And so today, NICE is the bad guy for cancer drugs again. Its draft guideline assessment - not final - is that £21,000 is overly expensive for Avastin's ability to stop or shrink tumour growth in patients with advanced bowel cancer, in conjunction with other chemotherapy drugs.

NICE suggests that the usual gain is of six weeks of life. If you accept this figure as a working average, then the cost per week gained is £3,500. Per day, it's £500.

That would mean that if the £50 million allocated to the National Cancer Drugs Fund from October to next March were all spent on Avastin, it could give 2,380 year-long courses of treatment at £21,000. That would not of course necessarily map to 2,380 patients - it would all depend on the impact it had on longevity. It is merely to illustrate how quickly that money will go.

NICE is the least worst method of addressing the problem of drugs' claimed clinical effectiveness in relation to their demonstrable cost-effectiveness. Not for nothing are countries around the world seeking to emulate it, however their healthcare system is organised and funded.

NICE chair Professor Sir Michael Rawlins gives an interview to todays' FT, in which he suggests that the  complexity of risk-sharing arrangements should be replaced with a simple 1/3 up-front price cut for expensive new drugs until their efficacy is demonstrated.