Monthly Archives: August 2009

The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. Their guidance is supposed to take into account both clinical and cost effectiveness but many of their decisions can appear arbitrary.

For example, NICE have restricted the use of donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon) for patients in the early stages of Alzheimer’s disease, forcing patients to wait for their condition to deteriorate and worsen before these drugs can be proscribed. Lucentis, a drug designed to save eyesight is likewise restricted for many relevant conditions.

Although there are savings to be made on the cost of the drugs themselves (if not prescribed) in conditions such as those above, even in purely economic terms these are surely outweighed by the resulting long-term care that will be needed in cases of Alzheimer’s and blindness (the Alzheimer’s drugs in question cost just £2.50/day). This is an area where the involvement of actuaries in the decision making process could be greatly beneficial as actuaries have applied common-sense and a tool-box of transferable skills.

An ageing demographic, increased longevity and the spiralling cost of long-term care need to be addressed by a review of pensions provision and where decisions concerning medical treatment are likely to affect the long term care needs of the patient, it is of direct interest to actuaries. The actuarial profession should lead the way and should be actively involved in this crucial decision making process.