Welcome to socialized medicine where cost of a medication is the first priority over anything else. Orencia is comparable in cost to the anti-tnf drugs
http://www.reuters.com/article/health-SP/idUSL01506951200708 02
This happens so often over here with drugs for all sorts of illness. It riles me when it is for cancers as its like the government is giving the death sentence to sick people. Well, I don't know if you can say socialised medicine is bad because NICERather than wait from Jan til August in pain for an appt. with an NHS rheumy I paid £200 to see one for less than 10 minutes... I then saw the same doctor on the NHS.... he runs an NHS clinic once a week.
The UK system isnt great, NICE do seem to make some difficult decisions but when I've needed the NHS they've been there for me. I had an emergency hysterectomy in Jun 2002 and 12 weeks later I had major back surgery.
What I've found is that if you need something urgently you get it... I think they run on crisis management. But its totally different with regards to expensive medicines. My son has been on treatement since he was 15 when he finishes (hopefully this month if not then it will be the end of the year), he will have cost my doctors 'special budget' £300k...like I say we had to go through hoops to get there though.
NICE have been persuaded by public opinion on a number of occasions recently to change their minds about drugs. I want to know why if there are so many ill people that the drug companies need to be so greedy. I understand the stuff about paying for all the research costs/trials before a new drug can be opened up into the arena but surely if there are hundreds of thousands of people needing a drug then it should be made available cheaply.... the drug companies will make their money... but I suspect their share holders woudnt be happy with smaller dividends each year.
Rant over I'm off to Pilates.
People in the UK can pick their doctors to an extent, just not right down to the name and place like you people can in the States. We have a choice of which surgery to register with, and then you can ask to see a particular doctor in accordance to your particular problem. If you have to have a referal your GP is meant to offer you a choice of 3 different hospitals which are local and cater for your problem. Once there if you are not happy you can ask to change consultant. Obviously if you go privately then you a bit more choice, but a lot of that is still down to the doctor writing the referal.
Did I single out Canada..no
But for you to wear rose colored glasses and say there are no problems with Canadian healthcare simply because YOU haven't experienced them is as naive as me trying to say the U.S doesn't have problems because I haven't experience them.
Don't assume you know my beliefs about the U.S. health care system because I can assure you that you don't.
We need to make changes in the U.S. in how healthcare is paid. There is a major gap in coverage for the working poor nobody disputes that. To cover these people will require some sort of government program..what shape that government program takes is still to be determined. That means taking a look at various programs throughout the world. The Good, the bad, and the ugly of those systems. To me that means guarding against a system where the availiabilty of medication to a group of patients is determined soley on cost, to me tat is guarding against a system that results in months long waiting lists for diagnostic MRI and CT scans, to me that means if I need a knee replacement I get to see a doctor at a time based on my medical needs and surgery when I need it not when I am at a top of a list.
You don't have to agree with this assessement, I really don't care if you do or not. The problems of the U.S. health system is not yours to worry about. And I only care about Canada's as they try to translate it into the States
Scattered, where are you? I think i need to move.In kent we do not have a choice of which surgery to go to. I tried 8 times to get into a surgery but was told there is one about 20 feet closer to my house so i have to go to that one. Since I have now moved I can go to the one I originally wanted to.Buckeye, I brought up Canada because in your very first post you wrote:Pin, I live in Northamptonshire but get treated by Oxfordshire PCT as my sugery is part of Oxfordshire. Due to the town I live in being on the border of 3 different counties it can get very mixed up as to where I get treatment. All the stuff I wrote above, I only found out by doing extensive research on government websites - it's all there but in the small print. I guess it's easier for them if patients aren't aware they have these rights. Surgeries do have catchment areas though, a bit like schools, so that might have been part of their decision for you.
I think the NHS is good idea but, like anything it's not perfect. NICE have some difficult decisions to make and one good thing that has come out of this is that the Health Secretatry is going to renegotiate how much drug companies can charge the NHS.
Gimpy,
I enjoy the back and forth, but could you try not to make it personal? From your last post, it seems to me, you can dish it out but you can't take it. As someone just reading both posts, you immediately get your back up if someone has a different opinion than yours. You have opinions about the US health care system all the time, so let others state opinions w/o going ballistic, like you are just looking for a fight. You are even telling someone from Britain, that you know more than they about their system and whom they should/or should not blame for inequities.
I like hearing both sides of the coin, and Buckeye, did nothing to insult you personally. Just take a deep breath before you post, OK?
I live in Britain and over the years have experienced good and bad things about our healthcare system. Currently there is an element of "postcode lottery" about GP services but the situation should be that you can go to any GP if you are in their catchment area (as defined by the Primary Care Trust - PCT) and they have space on their list for you. If you are having difficulties please please go to your PCT and complain - you pay a lot of tax to run these services and they should be playing by the rules! In terms of hospital treatment you can now choose which hospital you would like to be referred to by your GP - your GP should also be able to help with the choice and they can provide information on waiting lists etc BUT it may be worth waiting a little longer to be referred somewhere that specialises in the discipline - eg in West Yorkshire many patients come to Leeds to the Regional Rheumatology Centre. For ongoing hospital care you may be moved to a different hospital, particularly if the specialist centre is some distance from you. Yes some drugs are not licensed by NICE due to issues of cost-effectiveness (not sure that's a word!) and there are a few high profile campaigns at the moment but decisins do change - usually because new evidence becomes available. For example if drug X is shown in current studies only to have a 10% effectiveness and costs £20,000 they might initially say no to it, especially if there are other treatments available. Then if new studies are published that prove it is more effective or that in combination with other drugs it is more effective they might change the rules. Each PCT has the authority to prescribe drugs that NICE has not authorised (due to cost-effectiveness, not due to risk of harm) if they so wish but their budgets rarely allow this.
I agree with Scattered that NICE have tough decisions to make and I do believe that their decision on Orencia may change in the future. When I first started on Remicade just over a year ago I was told I was lucky as it had not been allowed for PA patients for a long time until studies could specifically prove it works for PA. Also for any Anti-tnf the Dr has to make a case to the PCT that your form of disease is severe enough and potentially damaging enough to warrant the treatment.
Finding out how other countries deal with this issue is interesting...
KT
The NHS is so under funded and sorry if I sound so negative about things but I havent had good experiences so far. I went to a doctor who diagnosed me with RA and within a week the same Doctor said I didnt have it and it was stress. I asked to be referred to another doc within the practice and he told me that I did have it and the first doc had noted it on the computer
I have had 6 hour waits at A&E before with a child who had fainted continously all day and when I had fallen down the stairs and couldnt walk or move my toes????
I witnessed an old woman who was laid flat on a trolley in A&E calling very softly for a drink, a nurse told her that they were very busy and someone would get her a drink in a little while. she started to convulse a few moments later- diagnosis Dehydration.
I do admit that the new system seems to be working a bit better with choose and book but things like scan and xrays are still so slow.
I had an MRI scan done in december last year, i waited almost 6 months for the results as my rheumy didnt have a spare apointment to look at them. I had a CAT scan on my sinus a few month ago and I have a major infection going on in my sinus and upper respiratory. I phoned the hospital and they said they dont have many radiologists and cat scans on the sinus's are way behind (maybe 4 to 5 mnths). I got hold of my ENT doc and i can only get an appointment with him at the end of September, meanwhile my G.P. ( NEW ONE) is brilliant and is trying to hold this infection for me with all sorts but even he is at the end of his tether with it.
I have written to my PCT and am still waiting for a reply
I found this site interesting. It ranks worldwide health care:
http://www.photius.com/rankings/healthranks.html
I went from #37 US to #58 South Korea. Hopefully, I won't find out what the difference is.
Becky
RA2003 AP2005 Remission 2007
Hey Crispy, I thought Buckeye's post was personal to me. Not sure what you[QUOTE=Gimpy-a-gogo]
Yes, Britain has a terrible health care system. So "terrible" that we are 18th in the world rankings and hmmm, Canada 30th, oh ner ner, PMSL
In Britain, 60,000,000 people can not get Orencia. I should hope not, that would be the entire UK population!
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I never said socialized medicine sucks. I essentially said a socialized system that allows COST to be the deciding factor about making valid treatments available sucks. Its my opinion..so shoot me.
As I pointed out in another post it is essential as Americans look towards the way other countrys deal with their medical system that we understand what pitfalls those systems may have. Why should we repeat the mistakes that occur, because if those problems occur in countries trying to deliver healthcare to much smaller populations those probelms will be magnified if not fixed before applying them to the American population
I am not anti-sociialized medicine. For goodness sakes both medicare and medicaid are socialized medicine. And any type of program that covers the U.S. un and under insured will be socialized. i just don't want to see the problems that other systems have brought here. We have the chance to learn from others mistakes. The U.S. system doesn't work for 50,000,000 people which means it does work for 250,000,000 people. We don't want to screw things up for 85% of the population to take care of 15%
Tinker, I already apologised---yeesh! And I know how irritating it is whenI know the US healthcare system has problems, many which could be fixed by making a couple of changes. But I'll tell you this, I live near the Canadian border and their are TONS of people that come over here to see a doc because they can't get an appointment at home. They like it better here, health care wise. And that's their words, not mine.
According to the rankings on the link someone posted.Hi Buckeye,
I think the issue is that decisions are made by NICE in the UK based on cost-effectiveness (rather than cost). So, as I said in my earlier post an expensive drug will be licensed if there is enough proof that it will work and that the benefits from it justify the costs. Those pesky reporters will always push the "nasty Gov't won't pay for drugs" angle without reporting the full story... There have been a few famous challenges to decisions recently - I think one was about a cancer drug that can extend the life of terminal patients - the patients won that one and one about a drug for alzheimers is on the go - it's been licensed for patients in the later stages but I think the campaign is to license it for all cases. Remember that there is a finite pot of money, I imagine we would think it irresponsible if they told us we can't see a Rheumatologist because they spent too much giving drugs that weren't proven to work and not likely to be successful. As I said earlier the system isn't perfect and they make poor decisions at times but a public healthcare system is open to challenge and that is what people are doing. How many people who pay for healthcare 'ration' their own treatment due to cost?
KT
Also, I wonder how many people successfully challenge their private