That's what makes this forum so valuable.

Until today I had never heard of the QALY. But now that I have, I can't get it out of my head.

It simply formulates what I already suspected, which is that economic consideration rule.

I just didn't realise how completely they rule.

This is one of those dammed if you do dammed if you don’t scenarios.

It’s an example of the biggest problem in human society. That being unlimited wants/needs but only limited resources.

Mrs McDonald should go to places like Thailand where they steal western drugs and sell they for 50c a pop. The same drugs may cost hundreds if not thousands of dollars in Australia. Why is this so? Because they drug developers need to be reward for coming up with a new drug which helps humanity. They need a big incentive because most drug development fails which causes big losses for those who gave there hard earned money to the company to try and create this new drug.

I think one way around this is creating a bounty system in which an international body reviews the effect of a drug and then pays the company a bounty and maybe some royalties in direct proportion to how effective the drug is. The drug can then be sold at fraction of the price it would be sold at in todays market place.

When it comes to human life, cost should not get in the way. Drugs which save human lives should be one thing which is ignored when it comes to economic efficiencies.

Pericles, excellent post, I felt I was getting nowhere fast.

RUawake, I googled QALY's and found the following, which is helpful to those of us who have never heard of the term before.

http://www.oheschools.org/ohech5pg4.html

"QALYs offer the possibility of carrying out effective cost benefit analysis and thus providing the information we need to make efficient decisions... The National Institute for Clinical Excellence (NICE) collects evidence on the cost per QALY produced by the treatments it appraises .... Some "life-saving" treatments are unpleasant, do not extend life much and the time remaining is full of pain and discomfort, while other treatments may not save lives but are not expensive and considerably improve the quality of life of the patient. ....

QALYs provide the best attempt so far to solve the problem of measuring health care outcomes but they still suffer from a number of serious problems. A key question is who is to make the subjective choices which determine the QALY?

Is it health professionals, the general public or patients who have experience of the particular medical condition and treatment?

Experiments have shown that the value of a QALY can change radically according to who is making the choices. Other problems include ... the responses given are to HYPOTHETICAL situations ... may not accurately reflect people's real decisions, and the fact that valuations are influenced by the length of the illness and the way in which the questions are asked. Finally, QALYs are likely to undervalue health care because they do not capture the wider benefits .... which may be gained, for example, by a patient's family and friends.

Developing QALYs .... promises to provide the information we need to judge whether health care is being produced efficiently or not. A more fundamental question is whether health care is really that vital for health?"

A complex issue that is as diverse as the people affected by it. And one thing we can count on is that we will be facing these ethical considerations at some point in our lives.

Apologies TRTL.

I should have read your post more carefully.

For the rest, posters may find interesting this article in today's Independent newspaper.

NHS SHOULD NOT SAVE PATIENTS' LIVES IF IT COSTS TOO MUCH, SAYS WATCHDOG

See:

http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/nhs-should-not-save-patients-lives-if-it-costs-too-much-says-watchdog-891501.html

Quote:

"Patients cannot rely on the NHS to save their lives if the cost of doing so is too great, the Government's medicines watchdog has ruled for the first time.

"The National Institute for Clinical Excellence (Nice) has said the natural impulse to go to the aid of individuals in trouble – as when vast resources are used to save a sailor lost at sea – should not apply to the NHS.

"The disclosure follows last week's controversial decision by Nice to reject four new drugs for kidney cancer even though they have been shown to extend life by five to six months."

I have a feeling many other state funded health care services are soon going to be saying similar things.