This question of drug (or even overall treatment) efficacy is a very complicated one. There are a >lot< of things that can determine whether a particular treatment is valuable for a particular case, it's seldom true that X is never better than Y. The age and sex of the patient, other complicating factors that might rule out the use of a particular drug/procedure, etc. We're now getting to the point that both the genetic profile of the patient and the pathogen/cancer can be used (and work well) in evaluating the treatment options.We talked earlier about how Germany would not pay more for new drugs that had no better efficacy than old drugs.
Then we have the cost issue: Say we have 2 options:
1) New Treatment X can be expected to give a particular patient a 5 year survival rate of 80%, has minimal side effects, and costs $200K
2) Existing Treatment Y is expected to give a 5 year survival rate of 70%, costs $20K, and has a good chance of serious long-term side effects.
Which one will the committee choose/allow? Which one would I choose for my wife? What if we were paying the whole thing? If we then determine that the government will use the "saved" $180K to provide vaccines and preventative care for 500 children, or save two lives through liver transplants, which option is then the best one?
It ain't simple or easy. Still, that doesn't mean we shouldn't try. I'll be happier when the choices are explicit, clearly explained to everyone, and we can make our decisions based on facts/responsible assessments rather than fear or opaque guidance. People deserve to know where they stand and the basis for decisions that affect them.
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