07 March 2007

Most Vocal Win In National Lottery

The Telegraph reports the latest anecdote about the NHS postcode lottery under the headline "Couple faced choosing which one of them should go blind" while the couple's local paper goes with "PCT caves in over blind couple's treatment" and begins its report, "Health bosses have been forced into an embarrassing U-turn after refusing to pay for the treatment of two pensioners facing blindness."

In actual fact, reading to the end of the article, it seems clear that a more accurate headline would have been: "Couple anxious while PCT evaluates their individual healthcare requirements" but we all know sensationalism sells.

Clearly this was the best story that could be found to back up the latest public campaign to force the National Institute for Health and Clinical Excellence (NICE) to make a decision concerning one of the drugs waiting for its approval. Yet, however serious the condition or however promising the new treatment, is it right that the work of NICE should so often be driven by whoever shouts loudest in the media?

Wet age-related macular degeneration (AMD) is the most common cause of blindness in Britain, affecting 26,000 people a year. Of these, just 7,000 can benefit from the only existing form of treatment, photodynamic therapy, while a newly-licensed drug, Lucentis (ranibizumab), has been shown to significantly improve visual acuity in up to 40% of patients.

The Royal National Institute for the Blind (RNIB) complains that 80% of primary care trusts are still not funding the sight-saving treatment and the Department of Health says that patients should not be refused a treatment simply because NICE guidance does not exist yet. However, were PCTs to start paying for the drug and NICE were subsequently to reject it for use in the NHS, then patients and doctors would be forced into the same position that Alzheimer's patients recently found themselves in when approval for the drug that was bringing relief to their condition was turned down.

Clearly, the House of Commons Health Select Committee conducting an inquiry into the work of NICE has some tough decisions to take.