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Why NICE is right to be nasty

Just how long does it take to attain 'closure' and 'peace' when you’re dying of liver cancer?

Just how long does it take to attain 'closure' and 'peace' when you're dying of liver cancer?

The British Liver Trust and Macmillan Cancer Support are frustrated and scandalised by NICE's decision not to authorise the use of sorafenib in cases of advanced liver cancer purely on the grounds of expense.

No-one is doubting that the drug is effective in that it prolongs life by a few months. It's just that each of those months costs the NHS £3,000.

It's not as though a diagnosis of terminal liver cancer is sprung upon an unsuspecting patient – this is a drug designed for use when all other treatment options have been tried and seen to fail.

Which brings me back to my opening question. Patients' families are campaigning for the drug to be used to offer their loved ones a few 'precious' extra weeks at the end of their illness. I'm not going to make value judgements here except to say that all the weeks I have could be viewed as 'precious' from my point of view and to wonder whether the last chocolate truffle in the packet really tastes any different from the first.

If the family really need the extra few weeks they can now use the top up system to buy the drug for themselves without compromising the rest of their loved one's NHS care. If it's that important, cancel the order for the plasma screen, put up with the taunts about having last year's X-box, get a loan.

John Wesley told his congregation that it was possible to convert to Methodism and have their sins washed away in the time it took to fall from a horse. Some people don't get the chance to achieve closure or peace at all. They just die suddenly and leave their families bereft.

So it might seem harsh but I'm going to applaud NICE for making a difficult decision. The money could and should be spent on treatments that offer hope of a cure.

And the families should start lobbying the big pharma fat cats to drop their prices.


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