ICER Watch: Immunotherapy Restricted in United Kingdom
The Institute for Clinical and Economic Review is working to reduce patients’ access to life-saving treatments. Don’t believe us, just look at health care in Great Britain — NICE is their model.
The National Institute for Health and Care Excellence — the British equivalent of ICER – is blocking patients with kidney cancer from obtaining access to immunotherapy. The bureaucratic agency charged with controlling health care costs has decreed that nivolumab has “substantial uncertainty” for increasing the survival benefit for patients with previously-treated advanced renal cell carcinoma. Therefore, it’s denying the treatments for patients in the country’s national health care system.
Kidney Cancer UK, which advocates for patients with the disease, says NICE’s ruling is unacceptable.
“We were optimistic of good news in the light of the scientific data surrounding nivolumab, so are bitterly disappointed that NICE will not recommend nivolumab in October at this point,” said the charity’s chief executive, Nick Turkentine. “This is a drug that data shows, and from first hand conversations we have had with patients taking part in trails confirms, a higher quality of life through drastically lowers side-effects, is a much less intense regime of treatment, and offers extended life expectancy to those with advanced stage kidney cancer.”
ICER’s cost controls and value frameworks will impose similar restrictions here in the United States. The harmful effects aren’t hypotheticals. They’re already happening around the world.
The Future of Wearables
While we’re digitally across the pond, check out the Financial Times story on the development of wearable technology.
New developments are likely to improve our health care. As one example, researchers at the Massachusetts Institute of Technology have found monitoring skin for electrical changes can detect fatal seizures.
“Wearables are going to be much bigger than anyone imagined,” says Rosalind Picard, founder and director of the Affective Computing Research Group at the MIT Media Lab.
Much of the potential for wearable or implantable devices is linked to the progress in computing power. In keeping with Moore’s Law, computing power doubles every two years, providing the technological capability for miniature devices..
“You have a massive increase in the capacity to communicate, to analyse data and to provide individuals with supercomputers right in their pockets,” says Olivier Leclerc, digital head of the global pharmaceutical and medical products practice at consultants McKinsey. “Miniaturisation has been playing out for a while but it’s now starting to make an impact.”
State Spotlight: Connecticut Closes Co-ops
Connecticut is closing its health insurance co-ops.
Morning Consult reports that the Connecticut Insurance Department has restricted the state’s non-profit insurer from offering new plans or extending current plans after this year. That’s the consequence of the Centers for Medicare and Medicaid Services announcement that the co-op “would be required to pay $13.4 million as part of the program this year.
“As a result, it became evident that this risk adjustment mandate would put the company under significant financial strain,” said Connecticut Insurance Commissioner Katharine Wade. “This order of supervision provides for an orderly run-off of the company’s claim payment under close regulatory oversight.”
Should more attention be focused on preventing cancer?
Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, argues in a recent New York Times piece that, unlike heart disease, cancer prevention is often overlooked.
“As a physician, I have encountered many people who believe that heart disease, which is the single biggest cause of death among Americans, is largely controllable. After all, if people ate better, were physically active and stopped smoking, then lots of them would get better,” Carroll writes. “People don’t often seem to feel the same way about cancer. They think it’s out of their control.”
Carroll points to studies that show a link between:
- Diet and colorectal cancer
- Alcohol and esophageal cancer
- Tobacco and esophageal cancer
- HPV and cervical cancer
- Hepatitis C and liver cancer.
- Smoking and lung cancer
- Sun exposure and skin cancer
He concludes, “Simple changes to people’s behaviors have the potential to make sure many cancers never occur. They have a side benefit of preventing health problems in many other areas, too. Investment in these efforts may not be as exciting, but it may yield greater results.”
From our perspective, prevention and treatment aren’t mutually exclusive. We should be investing in finding better treatments, developing revolutionary cures AND educating people about preventative measures. But…
We can’t turn prevention into patient-blaming. Cancer is never the patient’s fault. And no one should be denied access to a life-saving treatment because “they should have done more to prevent their disease.”