Forbes: Don't Import British Methods For Rationing Access To Drugs
By Sally Pipes
Earlier this year, European authorities recommended approval of tofersen, a new drug that treats a rare genetic form of amyotrophic lateral sclerosis, or ALS. That decision came nearly a year after American regulators granted the drug accelerated approval.
Patients with that rare form of ALS in England aren't so lucky. The National Institute for Health and Care Excellence, or NICE, which evaluates whether treatments are "cost-effective" for the country's National Health Service, announced a decision in March that would effectively render the drug unavailable to them.
It's a story that British patients are far too familiar with. And it's a cautionary tale for American patients, as the Biden administration is trying to import some of the ideas Britain uses to ration access to cutting-edge drugs.
The Inflation Reduction Act, signed into law by President Biden in 2022, gives the federal government the power to set drug prices—and encourages the use of comparative effectiveness measures in doing so.
A Boston-based entity called the Institute for Clinical and Economic Review, or ICER, has been churning out comparative-effectiveness studies for years. ICER says that its research shows which drugs are worth their price—and which aren't.
ICER's stock in trade is the QALY, or "quality-adjusted life year." A QALY attempts to put a price on one year of healthy human life. A year of "perfect" health gets a higher value than a year of added life that includes living with an illness or other infirmity.
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Treatments for older people and those living with a chronic illness or disability thus yield lower QALY scores than treatments for younger and healthier patients. It's discrimination based on health status of the most blatant sort.
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