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NICE stripped of power to ban drugs


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The government has said it is intending to transfer the decision about which drugs should be provided by the NHS from NICE to GPs.

The role of the National Institute for Health and Clinical Excellence will be to offer advice about medication and the final call about which drugs are given to patients will be taken by GPs.

The Department of Health said that the change in decision-making would also see moves toward "value-based" costing for drugs.

Reports suggested that the Quality-Adjusted Life Year Threshold used by NICE (which is capped at around £30,000 per year) would be scrapped by 2014.

The changes come after Health Secretary Andrew Lansley told the National Association of Primary Care conference in October that GPs were best placed to decide if their patients required certain types of drugs.

This announcement has led to warnings that GPs might become health service "scapegoats" in the next few years.

Mr Lansley said the changes would aid the health service keep track of progress in medical technology and would cut costs.

"We will move to an NHS where patients will be confident that where their clinicians believe a particular drug is the right and most effective one for them, then the NHS will be able to provide it for them," he said.

NICE said they were in favour of the changes. Chief executive Andrew Dillon said: "We support moves to extend access to new treatments at prices which reflect the additional value to patients."

Although this does not directly affect OCD at the moment, it might have done if some new expensive drug ever became available. Hopefully, if I am reading this correctly NICE who will have the expertise on a specific subject will still offer advice on the most appropriate drug, so GPs with little knowledge on the subject will not be making the decision blind, but this offers flexibility. Let's hope Mr Lansley has a budget for it.

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Guest Wombat142

Let's hope, yes...

Another problem occurs to me. NICE is a national body - if NICE says you're entitled to a drug, you're entitled to it, wherever you live. If the decision was up to GPs, surely in practice they might have to take account of how the year's budget is holding out. I worry that patients in Rochdale (where I live) and other perpetually broke areas could be refused expensive drugs, while others got them without question. I believe NICE was partly set up to stop this "postcode prescribing". Another example of the coalition's great policy of "it's your own fault for not being rich"?

I'm not quite sure of the details, but if this change was made, could it pave the way to applying the same principle to other treatments? I wouldn't want to see the entitlement to CBT for OCD patients left up to the GP's discretion. As Stephanie Fitzgerald's article in the latest issue of "Compulsive Reading" indicated, there are still far too many GPs who don't always see the importance of trying CBT. A good article and a good magazine, by the way - well done all!

All the best,

Wombat142

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As Stephanie Fitzgerald's article in the latest issue of "Compulsive Reading" indicated, there are still far too many GPs who don't always see the importance of trying CBT. A good article and a good magazine, by the way - well done all!

Thank you Wombat, I will pass your kind words on to Steph. She will be expanding beyond the article and talking more about how to access treatment at the conference, will you be able to attend, would be nice to meet you at long last.

Another problem occurs to me. NICE is a national body - if NICE says you're entitled to a drug, you're entitled to it, wherever you live.

In theory yes, but the problem is, and I have experienced this with people I have helped, the NICE guidelines are just that, guidelines so now and then some Dr's have pointed that out to me, and if they think a patient is better treated another way, they can go down that route. Although, on both thosr occasions the patient did not agree with the Dr, so I rammed the NICE guidelines back down the said Dr's throats :whistling: (not physically of course lol)

If the decision was up to GPs, surely in practice they might have to take account of how the year's budget is holding out. I worry that patients in Rochdale (where I live) and other perpetually broke areas could be refused expensive drugs, while others got them without question. I believe NICE was partly set up to stop this "postcode prescribing". Another example of the coalition's great policy of "it's your own fault for not being rich"?

I totally agree with you Wombat, I am deeply worried about what is happening. The system we had under Labour had its faults, but it offered some degree of fairness across the board, under the new government I am worried, although I am hoping I am reading between the lines incorrectly. We again last week sent a formal invite to our health secretary Andrew Lansley to come and address the conference about the future for MH under the present government. Although he has rejected the previous two invites, I explained that we are next to his constituency, and that we have senior NHS professionals from the field of OCD and his own constituents in attendance who would welcome the opportunity to hear from him. I would like to hope he would value us enough to come and address us for 5 minutes, but we shall see.

Regards,

Ashley.

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Guest Wombat142

I'd like to come to the conference, but the way I'm placed at the moment, a trip to Cambridge really wouldn't be possible. You'd think Andrew Lansley could manage it, though, seeing that it's his own constituency... Maybe he actually will this time. I'd be interested to see what he says if he does!

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