4 ms·

> This seems to be pushing a myth: expensive treatments must be better treatments, right? We have very good evidence that these new, expensive, treatments do no

> This seems to be pushing a myth: expensive treatments must be better treatments, right? We have very good evidence that these new, expensive, treatments do not extend life and that they make quality of life worse. It's not pushing any myth at all. As explained elsewhere government-run systems like the NHS do attach actual dollar amounts to treatments that are effective and do extend life, but for which they're not willing to pay. The NHS's version is actually quite ruthless when you peel back the details, where they determine how "good" a person's life is, and essentially how much they are willing to spend to extend that person's life by N years. This is, in effect, a benefits cap, just framed slightly differently. This is not, as you are implying, saying "this treatment is ineffective or harmful, so we won't pay for it". It is literally saying "we understand that this treatment would extend this person's life by 5 years, but it costs £50,000, and based on their condition, we're only willing to spend £25,000 to extend their life by 5 years. > And yet it has worse outcomes across a range of measures, including "life expectancy". Life expectancy has so many confounding variables which have a much stronger effect that it's ridiculous to try and use that as a measure of a healthcare system directly. It's like trying to measure the fuel efficiency of different models of cars by looking at the total number of miles driven by all drivers of each car model in a given year. Yeah, there's... a connection between the two, but that's certainly not what you're analyzing when you try to compare them naively.

DanBC 8y ago
> where they determine how "good" a person's life is No they don't. This is not true. > This is not, as you are implying, saying "this treatment is ineffective or harmful, so we won't pay for it". It is literally saying "we understand that this treatment would extend this person's life by 5 years, but it costs £50,000, and based on their condition, we're only willing to spend £25,000 to extend their life by 5 years. This is just not true. Find just one single medication that i) extends life by 5 years ii) costs just £10,000 per year and iii) has been banned.
- chimeracoder 8y ago
  > No they don't. This is not true. That is literally what QALY is. > Find just one single medication that i) extends life by 5 years ii) costs just £10,000 per year and iii) has been banned. It seems like you don't understand how coverage works for cancer treatment. The question isn't whether the medication is banned outright - it's whether it will be approved to be used for a specific patient in their treatment plan (paid for by the NHS).
  - DanBC 8y ago
    > It seems like you don't understand how coverage works for cancer treatment. The question isn't whether the medication is banned outright - it's whether it will be approved to be used for a specific patient in their treatment plan (paid for by the NHS). Please tell me how you think cancer drug funding works in England, because I'm pretty sure you're wrong. But let's assume for the moment that you're right: please link to an article about a patient who would have been kept alive for 5 years if they'd been given treatment but they were denied the treatment because it cost more than £50,000. If anything the UK was spending too much on cancer drugs that provided no benefit - no extension of life, combined with unpleasant side effects that lowered quality of life. https://www.newscientist.com/article/dn26785-the-uks-cancer-drugs-fund-does-more-harm-than-good/ https://www.newscientist.com/article/dn26785-the-uks-cancer-... https://www.bbc.co.uk/news/health-35494660 https://www.bbc.co.uk/news/health-35494660
    - chimeracoder 8y ago
      > Please tell me how you think cancer drug funding works in England, because I'm pretty sure you're wrong. Just to be clear: you're telling me that you think QALY calculations are not factored into the decisions of which treatments will be covered for an individual cancer patient under the NHS?

DanBC 8y ago

> where they determine how "good" a person's life is No they don't. This is not true. > This is not, as you are implying, saying "this treatment is ineffective or harmful, so we won't pay for it". It is literally saying "we understand that this treatment would extend this person's life by 5 years, but it costs £50,000, and based on their condition, we're only willing to spend £25,000 to extend their life by 5 years. This is just not true. Find just one single medication that i) extends life by 5 years ii) costs just £10,000 per year and iii) has been banned.

chimeracoder 8y ago
> No they don't. This is not true. That is literally what QALY is. > Find just one single medication that i) extends life by 5 years ii) costs just £10,000 per year and iii) has been banned. It seems like you don't understand how coverage works for cancer treatment. The question isn't whether the medication is banned outright - it's whether it will be approved to be used for a specific patient in their treatment plan (paid for by the NHS).
- DanBC 8y ago
  > It seems like you don't understand how coverage works for cancer treatment. The question isn't whether the medication is banned outright - it's whether it will be approved to be used for a specific patient in their treatment plan (paid for by the NHS). Please tell me how you think cancer drug funding works in England, because I'm pretty sure you're wrong. But let's assume for the moment that you're right: please link to an article about a patient who would have been kept alive for 5 years if they'd been given treatment but they were denied the treatment because it cost more than £50,000. If anything the UK was spending too much on cancer drugs that provided no benefit - no extension of life, combined with unpleasant side effects that lowered quality of life. https://www.newscientist.com/article/dn26785-the-uks-cancer-drugs-fund-does-more-harm-than-good/ https://www.newscientist.com/article/dn26785-the-uks-cancer-... https://www.bbc.co.uk/news/health-35494660 https://www.bbc.co.uk/news/health-35494660
  - chimeracoder 8y ago
    > Please tell me how you think cancer drug funding works in England, because I'm pretty sure you're wrong. Just to be clear: you're telling me that you think QALY calculations are not factored into the decisions of which treatments will be covered for an individual cancer patient under the NHS?