Reflection: It's a NICE start to C8

Pleased to say I was "fighting fit" (by just a couple of days!) to go into full therapy for the start of cycle 8 yesterday, and - thanks as always to the steriods, I'm feeling "pretty good" this morning.

But not so good about a blog posted yesterday by Cass (awasandawillbe.blogspot.co.uk), in which she says the number of "no shows" for chemo treatment shocks the nurses.  Not only the impact of missing lifesaving treatment, but also the cost!  She believes her treatment costs the NHS circa £20,000 for six months; and mine with more sessions and more intense therapy will be even more - it's scarey to think how much it costs us (via taxes) when someone does not turn up for treatment...

...which is why I believe so strongly in NICE (do not tell the papers!).  If your not from the UK you'll not know that the UK's "National Institute for Heath and Care Excellence" provides the NHS and others with definitive...

"...guidance [that] sets the standards for high quality healthcare and encourages healthy living"

With one of it's tenets being:

"Good value for money, weighing up the cost and benefits of treatments" 

Which I interpet as "affordability".  

Is it affordable to give me the treatment I am getting (assuming I show up!)?  Yes!  Would it still be affordable if I was 86 and not 56?  I'd like to think the answer would be a resounding "NO!", whether I was otherwise healthy or not - I just cannot see the value to either me the 86 year old patient or our hard pressed NHS.  Equally, and probably just as controversial to some "news"papers, I would have fully understood if my cancer had been "the wrong one" for Cetuximab:  while I understand it could have had some effect in that case,  the benefit (i.e. the probability of a good outcome) would have been so small as to make spending that cash on something else far more sensible.  (Cetuximab is frighteningly expensive!)

So how do we react when we see an article in the news about "NICE controversially(sic) recommending not to prescribe new drug X for condition Y in population Z"?  In the text somewhere it will reference the number of people who might benefit (often small) from X (even more expensive than Cetuximab).  What is unlikely to be in the article is the observation that spending the same amount on a different new treatment applicable to a larger group who have a better chance of a good outcome might be a better option.  It's all in the numbers...