Privatise the NHS

[Fop 1]

http://www.bmj.com/cgi/content/full/337/ju...3e94c0830ba845c

 

The decision was made in the UK on the basis of this analysis.

 

Aye, and I have the Brooklyn Bridge to sell as at very reasonable cost.

 

 

If you want to call that PR, i'll have to call you insane. The Health Protection Agency believes that programme will generate 80,000 QALYs (thats life years adjusted for quality). They came to that conclusion independently. If its a good deal in the UK, its a good deal anywhere. the fact of the matter is prevention is the highest value intervention you can make in any are. The price is fuck all too.

Ah, reading that reminded me that the immunity isn't forever as well. No point in destroying something when you can create an addiction instead.

 

 

Who are you talking about in the US btw? You know you dont need to do subtle marketing in the US, you just advertise the drug on the telly.

They won it for the whole "only one life" idea, which of course works quite well, because it appeals to everyone (so long as you ignore the cost), and by setting up infomercial sites [ http://www.tellher.ie/ ]and campaigns that seem like independent health warning sites yet are just branches of the drug company.

 

It's all very effective so long as you don't peak or know what is behind the curtain.

[ChezGiven 0]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

 

You're not even trying.

[Fop 1]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

[ChezGiven 0]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

[Fop 1]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

 

£22,500 per QALY then , it still doesn't stand up well to dementia treatment that has been refused or quite a lot of cancer drugs.

 

Or to put it another way why is NICE refusing to pay for stuff that comes in at less than £22,000 per QALY if that figure is "cost-effective"?

[ChezGiven 0]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

 

£22,500 per QALY then , it still doesn't stand up well to dementia treatment that has been refused or quite a lot of cancer drugs.

 

Or to put it another way why is NICE refusing to pay for stuff that comes in at less than £22,000 per QALY if that figure is "cost-effective"?

 

You're probably reading a commercially funded analysis

[Fop 1]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

 

£22,500 per QALY then , it still doesn't stand up well to dementia treatment that has been refused or quite a lot of cancer drugs.

 

Or to put it another way why is NICE refusing to pay for stuff that comes in at less than £22,000 per QALY if that figure is "cost-effective"?

 

You're probably reading a commercially funded analysis

 

But that's not an answer is it.

 

Like I said good suit, but can't answer the awkward ones.

 

 

 

 

So is £22,500 per QALY "cost-effective" or not then?

[ChezGiven 0]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

 

£22,500 per QALY then , it still doesn't stand up well to dementia treatment that has been refused or quite a lot of cancer drugs.

 

Or to put it another way why is NICE refusing to pay for stuff that comes in at less than £22,000 per QALY if that figure is "cost-effective"?

 

You're probably reading a commercially funded analysis

 

But that's not an answer is it.

 

Like I said good suit, but can't answer the awkward ones.

 

 

So is £22,500 per QALY "cost-effective" or not then?

 

It was a joke. Nevermind.

 

Yes, 22.5k is acceptable. If NICE came to this conclusion, it would be approved. Therefore, as hinted in my joke, i wonder if you have seen this figure in a publication rather than in a document NICE produced. You obviously get wildly different estimates depending on who you ask.

 

If it is in a NICE doc, then post the link up.

[Fop 1]

So 2 non-sequiturs and a factually incorrect response about how effective it is and how much it costs?

Again when you look at the number of deaths per year and the total vaccination cost, the cost effectiveness just isn't there.

 

Like I said it was an astroturfing master class, selling something as very sexy that clinically isn't very cost effective at all.

 

 

 

It is pretty interesting that NICE isn't involved however, especially when contrasted with dementia drugs and the £30,000 per QALY suggested in that report (or even other cancer drugs with that or lesser "value").

 

Fig 1 in the BMJ article gives you the data you are missing. 100% probability of being less than 30k.

 

The total cost is small, otherwise it wouldnt be happening. NICE isnt involved as vaccination programmes are tendered directly with the DH. They use the same spending limits that NICE use though, hence why this is approved. If it was really expensive, the NHS wouldnt be able to afford it

 

This is an objective a decision-making process as you can get, so the idea that its due to PR influence is absurd. How personal was this experience of dementia?

 

£22,500 per QALY then , it still doesn't stand up well to dementia treatment that has been refused or quite a lot of cancer drugs.

 

Or to put it another way why is NICE refusing to pay for stuff that comes in at less than £22,000 per QALY if that figure is "cost-effective"?

 

You're probably reading a commercially funded analysis

 

But that's not an answer is it.

 

Like I said good suit, but can't answer the awkward ones.

 

 

So is £22,500 per QALY "cost-effective" or not then?

 

It was a joke. Nevermind.

 

Yes, 22.5k is acceptable. If NICE came to this conclusion, it would be approved. Therefore, as hinted in my joke, i wonder if you have seen this figure in a publication rather than in a document NICE produced. You obviously get wildly different estimates depending on who you ask.

 

Stats are like marketing they can be made to show whatever you want, which makes the whole thing very iffy when so much political pressure is around, but ignoring that.

 

 

 

 

So why are treatments of less than £22,500 per QALY deemed not cost effective then?

 

 

 

 

And more to the point of this thread what would it cost to allow the entire population of the UK any possible treatment up to this supposed "cost effective" limit of £22,500 per QALY?

[ChezGiven 0]

Point 1 - agreed, thats why i firmly belive that the Popperian principles of Evidence based medicine will best serve society.

 

Point 2 - because someone deems it more than 30k, basically saying its not 22.5k. If you post up the doc that shows this, i'll happily have a look at it.

 

Point 3 - would require a statisitcal model beyond my capabilities. Many people argue that implementing all possible interventions with less than a 30k price would bankrupt the NHS. They use this to argue for a lower threshold. Not good.

[Fop 1]

Point 1 - agreed, thats why i firmly belive that the Popperian principles of Evidence based medicine will best serve society.

 

Point 2 - because someone deems it more than 30k, basically saying its not 22.5k. If you post up the doc that shows this, i'll happily have a look at it.

 

Point 3 - would require a statisitcal model beyond my capabilities. Many people argue that implementing all possible interventions with less than a 30k price would bankrupt the NHS. They use this to argue for a lower threshold. Not good.

 

1. Yup, which makes this whole argument based on sand.

 

2. Relating to point 1 again makes it anything anyone wants to be in real terms.

 

3. You've got to have a rough cost otherwise what you are saying makes no sense, personally I think it would be astronomical (which goes back to the whole UK benefits system issue), but that would be the case private or NHS based.

[Guest alex]

I don't that link will be forthcoming btw.

[Fop 1]

I don't that link will be forthcoming btw.

There's loads of stuff out there, assuming that reports conclusions are in anyway genuinely accurate (although I'm not paying for a journal link that you wouldn't be able to read without paying for too ), although one of the problems with QALY's is that they only take direct cost into account, not social welfare costs and such. Which double fucks up issues like dementia.

 

Although the irony there is of course that drug companies want access to that market, although in fairness maybe it is outweighed by profit brought in by keeping them doped up instead.

[ChezGiven 0]

Point 1 - agreed, thats why i firmly belive that the Popperian principles of Evidence based medicine will best serve society.

 

Point 2 - because someone deems it more than 30k, basically saying its not 22.5k. If you post up the doc that shows this, i'll happily have a look at it.

 

Point 3 - would require a statisitcal model beyond my capabilities. Many people argue that implementing all possible interventions with less than a 30k price would bankrupt the NHS. They use this to argue for a lower threshold. Not good.

 

1. Yup, which makes this whole argument based on sand.

 

2. Relating to point 1 again makes it anything anyone wants to be in real terms.

 

3. You've got to have a rough cost otherwise what you are saying makes no sense, personally I think it would be astronomical (which goes back to the whole UK benefits system issue), but that would be the case private or NHS based.

 

No, i think you'll find that the principles of evidence based medicine drove this decision and therefore Karl Popper's philosophy of science is embedded within it. That goes for points 1 and 2.

 

As for the 3rd point, the NHS is a fixed budget system, so basically what would happen is that you start with the lowest priced interventions and exhaust all possibilities until the budget runs out. A practical and admiminstrative nightmare. Anyway, the point being that the total cost of this would be the budget itself (around 80bn)!. The question, coming full circle, is which system would be more cost-effective, private or public?

[ChezGiven 0]

I don't that link will be forthcoming btw.

There's loads of stuff out there, assuming that reports conclusions are in anyway genuinely accurate (although I'm not paying for a journal link that you wouldn't be able to read without paying for too ), although one of the problems with QALY's is that they only take direct cost into account, not social welfare costs and such. Which double fucks up issues like dementia.

 

Although the irony there is of course that drug companies want access to that market, although in fairness maybe it is outweighed by profit brought in by keeping them doped up instead.

 

"fop unwittingly found himself on the same platform as 'evil pharma"

 

 

Telll me the reference, i have access to every medical journal online for free.

[Fop 1]

Point 1 - agreed, thats why i firmly belive that the Popperian principles of Evidence based medicine will best serve society.

 

Point 2 - because someone deems it more than 30k, basically saying its not 22.5k. If you post up the doc that shows this, i'll happily have a look at it.

 

Point 3 - would require a statisitcal model beyond my capabilities. Many people argue that implementing all possible interventions with less than a 30k price would bankrupt the NHS. They use this to argue for a lower threshold. Not good.

 

1. Yup, which makes this whole argument based on sand.

 

2. Relating to point 1 again makes it anything anyone wants to be in real terms.

 

3. You've got to have a rough cost otherwise what you are saying makes no sense, personally I think it would be astronomical (which goes back to the whole UK benefits system issue), but that would be the case private or NHS based.

 

No, i think you'll find that the principles of evidence based medicine drove this decision and therefore Karl Popper's philosophy of science is embedded within it. That goes for points 1 and 2.

 

Hmm..... the whole concept of a QALY doesn't seem to be based on that (at least in anything more than lip service), or at least there or plenty of people and studies that would disagree.

 

As for the 3rd point, the NHS is a fixed budget system, so basically what would happen is that you start with the lowest priced interventions and exhaust all possibilities until the budget runs out. A practical and admiminstrative nightmare. Anyway, the point being that the total cost of this would be the budget itself (around 80bn)!. The question, coming full circle, is which system would be more cost-effective, private or public?

 

Easy, the one that generated most profit (from your point of view).

 

But that still goes back to who pays for everyone else, and indeed the benefits system, that is so closely tied to the NHS - which again hasn't exactly become a cost effective nirvana since privatisation was introduced there.... although a lot of people have made a lot of money, including an ex-pig farmer I know that genuinely couldn't spell his own name, but got in on that game at just the right time and has made an awful lot of money from it.

[Fop 1]

I don't that link will be forthcoming btw.

There's loads of stuff out there, assuming that reports conclusions are in anyway genuinely accurate (although I'm not paying for a journal link that you wouldn't be able to read without paying for too ), although one of the problems with QALY's is that they only take direct cost into account, not social welfare costs and such. Which double fucks up issues like dementia.

 

Although the irony there is of course that drug companies want access to that market, although in fairness maybe it is outweighed by profit brought in by keeping them doped up instead.

 

"fop unwittingly found himself on the same platform as 'evil pharma"

 

 

Telll me the reference, i have access to every medical journal online for free.

 

You seem to think I'm anti-capitalist or something , but in reality I just like to see a fair balance. And much like Thatcher's privatisations there's places where it works well and places where it doesn't.

 

I'm far from sure that it works in healthcare, and especially NHS based healthcare, even more so with the supporting social benefits structure in the UK.

[Park Life 70]

American has the worst, most expensive healthcare delivery and outcomes in the industrialised world.

 

thread closed\

Edited July 28, 2008 by Park Life

[ChezGiven 0]

American has the worst, most expensive healthcare delivery and outcomes in the industrialised world.

 

thread closed\

 

Way to ignore every single point in the thread. I'd rather get cancer in Germany than in the UK, thats for sure. Bit hypocritical of you not to be able to see past the deliberately provocative thread title too

[Fop 1]

American has the worst, most expensive healthcare delivery and outcomes in the industrialised world.

 

thread closed\

 

Way to ignore every single point in the thread. I'd rather get cancer in Germany than in the UK, thats for sure. Bit hypocritical of you not to be able to see past the deliberately provocative thread title too

 

Don't smoke, you'll live forever.

 

 

American has the worst, most expensive healthcare delivery and outcomes in the industrialised world.

 

thread closed\

 

[Rob W 0]

American has the worst, most expensive healthcare delivery and outcomes in the industrialised world.

 

thread closed\

 

 

welllllllllllllllllllll - it's better than no system at all but I agree the way it's organised as a Doctors Income Stream is obscene

[ChezGiven 0]

http://news.bbc.co.uk/1/hi/health/7714039.stm

 

I did say this was going to happen.

 

Paul Lynes, of Standard Life, said: "The products that could be developed will be a lot cheaper than comprehensive medical insurance so we are likely to see many more people take them up."

[Fop 1]

http://news.bbc.co.uk/1/hi/health/7714039.stm

 

I did say this was going to happen.

 

Paul Lynes, of Standard Life, said: "The products that could be developed will be a lot cheaper than comprehensive medical insurance so we are likely to see many more people take them up."

 

 

Of course it is:

 

 

£££££'s =

[Happy Face 29]

They want to nationalise the pharmeceutical companies rather than privatise the NHS.

 

[ChezGiven 0]

They want to nationalise the pharmeceutical companies rather than privatise the NHS.

 

 

How does the UK government nationalise a Swiss/US/German/French/Japanese business who operates across the globe?

 

Hmm. They had one in Russia way back when, didnt produce anything though.

 

The government has looked at this for ages and come up with the only sensible conclusion.