Comment on: 'The cost of a QALY'.
Sir,

We were interested but bemused to read the paper from Kirkdale et al. ‘The Cost of a QALY’.1

There is much to agree on. For example, ‘ … it is quite clear that the country’s purse is not deep enough to pay for every request and fund every need’. It is also easy to agree that the costs of drug development have to be recouped by companies, without whose continuing existence and financial viability, we would acknowledge, many effective new treatments would not emerge. We could not, however, agree that ‘many now feel that that NICE functions as a brake on Pharma profits and not solely to evaluate efficiency’. Nor could we agree that NICE’s use of a generic measure incorporating length of life with quality of life is misguided.

NICE processes can take time. Delays are often attributable to the many challenges to its decisions, but NICE’s activities should not be compared with those of the Food and Drug Administration which is a regulatory authority, akin to the European Medicines Agency. These bodies have the ‘simple’ job of assessing whether …