and
http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4127560&c=2
If I was a pharmaceutical rep I'd be rubbing my hands in anticipation of
lots of money just as many patients might be happy about the hope of a
longer, better quality life. In reality there will be limitations placed
on GPs.as well as pharmaceutical companies apparently.
"
The Department of Health says this development will be accompanied by a
move towards 'value-based' pricing, where the price of treatments 'will
reflect the value they bring'.
"
The level of standardisation of care is already fairly poor in the UK.
This step will ensure that this will increase. The pharmaceutical reps
have a much strong lobbying power to ensure their expensive products are
used rather than cheaper, older and slightly less effective medications.
Worst of all. I fear the drug companies will start doing what they do in
America: advertise to the public. The move to this sort of NHS moves a
lot of power to the patient as well as moving decision making power to
practtiicng physicians. This will bleed the NHS dry as the small value
of expensive treatments is marketed to uninformed lay people. NICE were
a wall against this.
I admit I@ve rocked up against NICE's clinical guidelines for
schizophrenia. I know more about mental health than the average bear and
can cherry pick reseaerch however don't have the expertise of a
qualified doctor nor the time to do the massive reviews of literature.
Personally I'm trying to think of a way to turn this decision to the
advantage of people with a diagnosis of schiziophrenia. If that means
starting an advertising campaign in GP, Pulse and the BMJ then so be it.
I'm trying to see the opportunity in what looks like a major challenge.
The challenge is the biomedical interpretation of schizophrenia, the
lack of mental health awareness in many GPs, the problem of front line
staff and the stigma of mental illness, the smaller unit size making it
hard to persuade a single entity of the value of a large scale facility
in London for first episode psychosis with low or no dose medication
based on a different principle to drugging people up and locking them up
till the drugs kick in. So I should be miserable about this.
Maybe it's the skunk, maybe it's eating more or maybe it's knowing I can
kill myself cleanly. Theres an opportunity for people who suffer severe
mental illness. NICEs evidence reviews didn't cover progressive and
fringe research. I don't think any of their team looked at the review
from Psychosis I highlighted to them because Psychosis is a relatively
new journal with no academic reputation. The view of medication as the
onl ything that makes for a better progonisis is a dogma inthe
establishment in psychiatry. It is rooted in biomedical thinking rather
than psychosocial outcomes though they're related of course.
The UK has just got to stop killing people with severe mental illnesses.
The recent report about whatever published by the RCPsych highlights an
astounding mortality risk where people with schizophrenia and bipolar
are dying 20 years earlier than the rest of the population. It's double
the estimate I'm used to hearing. Then there's the 5% employment rate
and SMR of 5 - both of which are some of the worst rates in Europe.
How is the Liberating the NHS White paper and the shift of purchasing
based on clinical evidence and experience going to affect those
outcomnes. Clearly the biomedical perspective of NICE has lead to the UK
leading Europe in killing and allowing the deaths of people with severe
mental illnesses.
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