Keith Brockbank
Recent activity
Comments (4)
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Comment on: Fast track drugs fears for NHS budget
I agree that funding for such a scheme could be problematic, and that this needs to be resolved before going ahead. However, the great advantage would be that the kind of evidence sought by NICE and other similar bodies from real clinical experience, building upon the pivotal studies carried out in order for the product to be licensed could be performed within the NHS. This could include, for example risk sharing approaches between companies and the NHS; and looking at longitudinal studies to establish whether there are specific responder groups. It would also mean that health economic models could be tested in the clinical environment so that real cost benefits could be established. Finally, I believe this type of approach may allow the partnership between industry and the NHS to investigate some of the wider issues, such as how to realise potential savings from prevention and early interventions.
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Comment on: Fast track drugs fears for NHS budget
I agree that funding for such a scheme could be problematic, and that this needs to be resolved before going ahead. However, the great advantage would be that the kind of evidence sought by NICE and other similar bodies from real clinical experience, building upon the pivotal studies carried out in order for the product to be licensed could be performed within the NHS. This could include, for example risk sharing approaches between companies and the NHS; and looking at longitudinal studies to establish whether there are specific responder groups. It would also mean that health economic models could be tested in the clinical environment so that real cost benefits could be established. Finally, I believe this type of approach may allow the partnership between industry and the NHS to investigate some of the wider issues, such as how to realise potential savings from prevention and early interventions.
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Comment on: NICE chairman hits back at critics
I know that NICE has an unenviable task - but should we not be absolutely transparent that its role is to support the NHS in a utilitarian approach to helathcare, based upon a premise of the maximum benefit for the maximum number of patients. This is not unreasonable, but does conflict with the aims of patient choice and consumerism which successive governments have also espoused. You cannot mix individualism and utilitarianism in the goals of a single service. It is also true that whilst the cost per QALY may be the best measure we currently have it in no way truly represents the value delivered by innovative treatments, and thus is very imperfect. What we really need is an agreed set of metrics of treatment value, which have been openly discussed in society, and an engagement with the public that the limitations of NHS resources define a level of value for money that we find acceptable. To allege that drugs are over-priced shows scant regard for the inward investment by pharmaceutical companies into NHS R&D activities and innovation that is required if we are to achieve the treatments we will need in the future and seems to me disngenuous on behalf of NICE.
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Comment on: Aidan Halligan on why Darzi needs clinical leadership
I disagree that clinical leadership is at odds with effective management. Co-operation and partnership between all relevant leaders, engaging all in essential change must be the best way forward. Tribalism between clinicians, professions, staff, and others is one of the most destructive forces at work within the service today. Leadership is no longer a matter of a few heroes going over the top and marching across no-man's land. Today's leaders, whether clinical or non-clinical will be those who will work together with colleagues from across the divides to provide the best care and treatment for patients.
