Intended for healthcare professionals

Letters Deadlock over cystic fibrosis drug

Allocating healthcare resources—seriously ill people should have priority

BMJ 2018; 361 doi: (Published 27 April 2018) Cite this as: BMJ 2018;361:k1817
  1. Malcolm Segall, retired paediatrician
  1. Tunbridge Wells TN2 5HN, UK
  1. msegall35{at}

MPs characterise NICE’s appraisal system as not fit for purpose following its non-approval of cystic fibrosis medication Orkambi on cost effectiveness grounds.1 What underlies this criticism?

NICE’s approach is utilitarian. It aims to allocate healthcare resources across the population so as to maximise aggregate health gain (allocative efficiency).2 It applies a standard criterion for cost effectiveness of interventions and thus distributes resources to …

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