nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, August 25, 2010

Gov't Healthcare At Work In The UK: How Cost Distorts Decisions

Controversy over Britain's decision not to fund the drug Avastin for bowel cancer.  Does extending a life for a couple of months on average justify the cost?

Go here for a video from the BBC on the topic.  The cancer treatment with this drug costs over $30,000.

The government makes the claim that the drug doesn't significantly benefit the patient who requires it.  They are a little "dodgey" (appropriate British slang?) on why they think it's not a benefit.

But the National Health Service in the UK is very above-board about their process of approving government funding for medical treatment:  they look at length of life, quality of life, and ....cost

This is why I think this is unethical:
1.  Quality of life is subjective, and personal...not a government assessment to make.
2.  The "high" cost of this drug is high relative to what?  A car?  Which is of more value:  a life or a car?

And most important of all:

3.  Average life extension due to a drug is ...well...average.  This means that if 1,000 patients get the drug, some are near death's door and will survive only a few days, while others may live for one or two years.  But the average comes out to be two months.

So, we condemn those who might have benefited greatly to an earlier death. [Note that I have exaggerated the statistical range of benefit for effect.  BUT, in some diseases the range is even longer than up to two years.  It depends on the disease, the treatment, and other things.  But you get the idea:  average life extension unfairly dooms some patients.]

The British healthcare system is broke, and other Euro systems are heading in the same direction.  They are cutting cost by cutting lives. 

The smartest countries, like the Netherlands and Switzerland, are introducing the market back into their system...but I still think they're just postponing the collapse.

This is what you get when the government makes healthcare decisions.  It becomes a budgeting problem.

Doc D

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