We asked you what you thought should be the primary concern on decisions over drug spending after health experts rejected government proposals that would see an assessment of the benefits a patient may have on society being taken into account when deciding whether to pay for new drugs.
- Sammie Engleby: Quality of life without a shadow of a doubt. Since when should we judge on whether a person is a benefit to society? The NHS has a moral obligation to treat regardless of age, race, gender etc.
- Dannie Hanlon: It goes against everything the NHS stands for! And who determines an individual's contribution to society?
- Anita Johnson: Everyone has a right to quality of life and most elderly have paid more into the system than any of us, so they should get what they are entitled to.
- Paula Hall: It's discrimination to choose based on an individual's contribution to society. Illness and quality of life should be primary factors.
- Nikki Arnold: This is an idea from those who know the price of everything and the value of nothing.
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We want to make sure we get the best possible results for all NHS patients with the resources we have, which means using taxpayers' money responsibly and getting good value for money.
– Department of Health spokesperson
That's why we have asked Nice to look at the way drugs are assessed so that patients can get the treatments they need at the best value for the NHS and the price the NHS pays is more closely linked to the value a medicine brings.
We understand that it's an important and complex issue on which many people will have views and Nice will be consulting widely on the proposals.
– Sir Andrew Dillon, head of Nice
This wider societal impact is such a sensitive issue. You can do it in a hard-nosed economic way, which is the department's calculation, but our sense is the wider public see wider societal impact as being more subtle than that.
And we're really concerned that we don't send out the message that we value life less when you're 70 than we do when you're 20.
Nice approves drugs costing less than £20,000 to give a year of good-quality life and Sir Andrew wants a similar formula to assess how a patient's quality of life is affected by illness, and then use this to estimate the social benefit of a treatment that could return them to full health.
Drugs that help older people live longer would be seen as having a "negative" social value because elderly patients take more from society than they can put back, under Government proposals.
The Department of Health has reportedly instructed Nice to re-examine how it assesses the cost-effectiveness of drugs to take into account the benefits successful treatments may have on society, such as allowing people to return to work.
But an assessment of the plans by Nice found that such plans would "inevitably take age into account to some degree".
Government proposals that would see an assessment of the benefits a patient may have on society being taken into account when deciding whether to pay for new drugs have been rejected by health experts.
The National Institute for Health and Care Excellence (Nice) dismissed plans by ministers that would see patients who contribute to the economy being given priority, The Times (£) said.
Sir Andrew Dillon, head of Nice, told the newspaper such an approach would leave the old at risk because younger patients would be seen as having more to gain from treatment as they could give more back.
A 2012 Oxford University study, published in The Lancet medical journal, showed that even very low-risk patients benefited from taking cholesterol-lowering statins.
Rory Collins, professor of medicine at Oxford University, worked on the research and said the number of people who could begin taking statins as a result of the new Nice guidance "would be in the the order" of around five million.
He added: "The evidence is very strong that the treatment is cost-effective at these lower levels. Doctors are now in a position to offer statins on this basis."
He said it was up to individual patients to decide whether they wanted to take statins, based on their risk assessment, but Nice's strategy would "reduce the burden on the health service".
The NHS estimates that statins save 7,000 lives a year in the UK.
Millions more people in the UK could be prescribed cholesterol-lowering statins in a bid to prevent more cases of heart disease, heart attacks and strokes.
In draft guidance to the NHS, which is subject to consultation, the National Institute for Health and Care Excellence (Nice) has cut the threshold in half for when doctors should consider prescribing the drugs to patients.
Statins are taken by as many as seven million people in the UK but this could rise dramatically - with experts predicting as many as five million more may have them prescribed.
At present, people with a 20 percent risk of developing cardiovascular disease within 10 years are offered statins, but this is being cut to include all people with a 10 percent risk of developing cardiovascular disease within 10 years.
The body which decides which drugs can be used by the NHS has defended reports that it spent £115,000 on luxury hotels and champagne bars.
The National Institute for Health and Care Excellence (Nice) said the money spent using taxpayer-funded credit cards was instead spent on business with all expenditure subject to strict approval.
A spokesman for Nice also said that claims in the Daily Mail it spent £3,346 at Searcy's champagne bars were inaccurate as the money was spent on room hire, not champagne.
Chief executive Sir Andrew Dillon said: "Nice has not spent money in champagne bars and the hotels used outside the UK were selected on the basis of the business requirements of the work involved.
"We use the public money entrusted to us carefully, not just because of our responsibility to advise the NHS on the effective and cost effective use of treatments, but because it's rightly what we are expected to do."
Professor Mark Baker, director of Nice's Centre for Clinical Practice, says that the "surveillance" protocol for men with slow-growing prostate cancer would involve "regular check-ups" instead of "radical treatment".
– Professor Mark Baker, nice
Prostate cancer can be very slow growing and whilst many men will have a cancer that won't cause them any harm in their lifetime, nearly 10,000 men still die every year in England and Wales.
The updated guideline includes a number of new recommendations on the swift diagnosis and treatment of different stages of the disease and a new protocol for men who choose active surveillance, which involves regular check-ups to see if and how the cancer is developing, rather than radical treatment.