QALYs in the community

doi:10.1136/bmj.39325.446019.3A

BMJ 2007;335:527-528 (15 September), doi:10.1136/bmj.39325.446019.3A

Letters

NICE behaviour

QALYs in the community

The first 150 words of the full text of this article appear below.

One of the major concerns of rheumatologists (who have beeninvolved with submissions to the National Institute for Healthand Clinical Excellence (NICE) for a series of expensive drugsfor the treatment of rheumatoid arthritis and other inflammatoryjoint diseases) is "what is contained in a QALY assessment."¹The answer, many believe, is not enough. If it were clear thatthere was a cost assessment of the potential reduction in orthopaediccosts, of the economic cost of putting someone on the sick register,or of the similar costs to carers, then we might be happierto accept that patients might be denied treatment.

If someone with rheumatoid arthritis is turned from a workingtaxpayer into a benefit recipient then the drug cost might betotally offset by the difference between the tax revenue lostadded to the disability benefits paid. For biological agents,which are often considered in people of . . . [Full text of this article]

Andrew N Bamji, consultant rheumatologist

Queen Mary's Hospital, Sidcup, Kent DA14 6LT

bamji@btinternet.com