Criticism of The National Health Service - Coverage

Coverage

The lack of availability of some treatments due to their perceived poor cost-effectiveness sometimes leads to what some call a "postcode lottery". NICE, the National Institute for Health and Clinical Excellence, are the first gatekeeper, and examine the cost effectiveness of new and relatively expensive drugs - most prescription is untouched by the guidelines they issue. Until they have issued guidance on the cost and effectiveness of new or expensive medicines, treatments and procedures, Primary Care Trusts are unlikely to offer to fund courses of treatment. The same of true of the Scottish Medicines Consortium, NICE's counterpart in Scotland.

There has been considerable controversy about the public health funding of expensive drugs, notably Herceptin, due to its high cost and perceived limited overall survival. The campaign waged by cancer victims to get the government to pay for their treatment has gone to the highest levels in the courts and the Cabinet to get it licensed. The House of Commons Health Select Committee criticised some drug companies for bringing in drugs that cost on and around the £30,000 limit that is considered the maximum worth of one QALY in the NHS.