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 been involved with submissions to the National Institute for Health and Clinical Excellence (NICE) for a series of expensive drugs for the treatment of rheumatoid arthritis and other inflammatory joint diseases) is "what is contained in a QALY assessment."1 The answer, many believe, is not enough. If it were clear that there was a cost assessment of the potential reduction in orthopaedic costs, of the economic cost of putting someone on the sick register, or of the similar costs to carers, then we might be happier to accept that patients might be denied treatment.

If someone with rheumatoid arthritis is turned from a working taxpayer into a benefit recipient then the drug cost might be totally offset by the difference between the tax revenue lost added 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


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NICE's cost effectiveness threshold
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