The Lancet has a brilliant editorial arguing why the cancer drug fund (set up by the last government in fact but launched early by this one) is intellectually bankrupt. If NICE looks at clinical and cost effectiveness surely a special fund that gives out drugs to patients who have exhausted existing lines of treatment is a kick in the teeth for evidence based medicine? And what makes cancer patients special? Mike Richards’ report ‘Extent and causes of international variations in drug usage’ was used to back up the claim that the UK is slow to adopt new cancer drugs. Which indeed may be the case but the report did not examine whether the drugs being used were efficacious. There are a raft of interesting reasons contained in the report about why uptake of drugs varies and not just in cancer. So clinicians may be more averse to toxicity (or related to this can empathise with patients perhaps and recognise side effects may put people off treatment), clinicians may favour non-pharmacological approaches or else other countries such as the US use more new drugs because of supplier induced demand and incentives to prescribe.
And this is closely linked to what patients want and expect from a healthcare system. The new government asked people what they wanted from the NHS and also how to save money, it would be good if these were explicitly linked. For now patient choice seems to reign: thus homeopathy is to stay in the name of patient choice.