Are we not worth it those who have paid in all our working life when people come here just for free medical help .surely we should have the major consideration

Ron Sealey, Croydon, GB

Sadly, this drug and others like it will not be available tp suffers in the UK.

Our Prime Minister this week gave £100,000,000 to the UN for operations in Africa. This is in addition to the £6,500,000,000 already earmarked for International Development for the year 2007/8. (see Treasury website)

While Mr brown is prepared to assign figures like these at the drop of a hat then it will be at the expence of the young and old of our countrymen.

Nigel Graham-Miller, Valencia, Spain

I would have a guess that the people who make these decisions,are not in pain or have to worry about paying for private treatment. Who are these people, I am sure we would all like to know who is making these decisions, they are faceless how do we find out who they are so they can be accountable for there decisions and answer too us.

J.HART, Hockley, UK Essex

People with sever rheumatoid arthritis live in excruciating pain which cannot be alleviated with palliative care. Steroid usage increases the risk of heart failure and strokes dramatically, even if taken for a short time. Heart failure drugs already cost the NHS a fortune. Stroke after-care costs the NHS and local councils a fortune. This refusal by NICE will condemn not only those with arthritis, but also their families and carers to a shortened life filled with both physical and emotional agony.

Anna Ellis, Rugby,

My newphew has been crippled by this disease for 10 years. He is 36 years old, unable to work and existing on disability benefit. In an attempt to control the disease he takes a lethal cocktail of drugs which are damaging him more than they are helping him which, in turn, leads to a higher dependency on the Nationa Healt Service. He is rapidly approaching a situation of needing daily care. How can depriving him of new drugs possibly be cost effectve - these new drugs just might provide the relief he so desparately needs to finally begin a self-sufficient life. Perhaps the National Institute for Health and Clinical Exellence hope he will be driven to end his life and therefore save them money - take heart, this state of affairs is not so far away as this young man feels he cannot endure this minute by minute suffering for much longer.

Julia Edge, Wrexam,

National Institure for Curtailing Expenditure, are doing their job well.

Rob Bain, Derby,

As National Insurance payers those sufferers are surely entitled to the best medical care the NHS can give. Will this stupid government stop wasting our money and start treating those who are suffering with some respect. It is about time that medical treatment is given to patients when needed and cost should not be a consideration. Why is it that in Wales they get free NHS prescriptions and we have to pay in England? This government is an absolute disgrace and needs to tighten up its act now.

Kristina Law, Leicester, UK

Why bother to do further research into any drugs if people are being denied the ones that do work. Enough charities are constantly begging for money for research - why? We are not going to be allowed the benefit of any research at this rate.

Norma, Halifax, UK

perhaps if someone at NICE lost the use of there hands due to athritis they would think differently but what,s the betting that it will be available in scotland very soon

d.jones, stafford, england

Might I suggest that people who read this and are as annoyed as I am about yet another denial of relief to sufferers on the grounds of 'cost ' remember this when the next general election is held?

Ian Gregory, Accrington,

Once again we see treatment denied. My daughter in law has kidney cancer. She is at present paying for Sutent, having been denied by the NHS. When the money runs out in a year, then she has around six months of life. Thanks NHS and NICE, If this mother of two very young children was a smoker, needed certain plastic surgery, was a drug addict she could get help. So the innocent suffer whilst those who choose to smoke or have a drug habit get help.

C, Darken, Nantwich, UK

Irresponsible. Incompetent. You have elected officials who do not know how to appropriately allocate resources (ala OFT report), and cannot make a simple prior authorization guideline to narrow the scope where abatacept will be cost-effective. Why not limit to people who have failed all other therapy? As to brian lee's comment about the US healthcare system (obviously a Michael Moore drone), the US healthcare system is one of the best in the world. It has its flaws, but that is due to lawyers (crazy settlements), greed (lawmakers, plaintiffs) driving up malpractice, and treatment of the uninsured. Without the US open economy model which bears the brunt of the world's drug costs, do you really think that (1) drug makers would be motivated to R&D new entities; or (2) drug costs in countries with "universal healthcare" would be so cheap? If the US went to a Canadian/European model, drug costs around the world in these socialized systems would skyrocket in order to offset the costs of R&D.

Jeff, Denver, Colorado

I suffer from Reflex Sympathetic Dystrophy, which really is a Cinderella condition. Very little research is being done into it and it doesn't feature in NICE's directives regarding pain relief at all. I live with constant and severe pain and, while there is a drug that would almost certainly alleviate my symptoms, it is only available to MS sufferers. While I have every sympathy with them, they are not the only ones living with pain on a daily basis. NICE seems to be devoid of all logic in a lot of its decisions and downright cruel in many more. If they or members of their families suffered from rheumatoid arthritis they would be outraged if they couldn't get the best treatment possible, likewise Alzheimer's, macular degeneration and so on. They need to experience living with these conditions, maybe actually spending some time with sufferers, before they make decisions that will blight people's lives perhaps irrevocably.

Yvonne Wilson, Norfolk, UK

Having waded through the OFT's report I am relieved to see the DoH finally getting the Government off it's backside to do something about drug pricing. PPRS has been a reasonable means of controlling manufacturers profits but has done little to control prices or demand for medicines. Let's hope a new scheme can be introduced to ensure that the NHS can continue to deliver more healthcare to more patients and save more lives!

Isabel Parker, London, UK

People can argue about where the line must be drawn on what treatments can and cannot be afforded in a public health system but unfortunately there has to be a line somewhere. I am sure that nobody wants people to be denied the best available options and I am certain that NICE have one of the worst jobs in the world trying to make the best of the constraints that operate, but the fact is that there is not enough money to treat everyone and everything. The government does have a clear duty to focus its health spending on getting the best "value" for society and can rightly be criticised for some of the wastage in the system but at the end of the day there is only so much money to go around and someone somewhere will lose out. All the talk of revolutions / elections etc will not change this.

mike, herne bay,

If developing new drugs is left to capitalist economics, it's inevitable that situations like this will arise. In this case, at least, the market has failed to meet a real need, and resources are being wasted on shareholders while people suffer. Choosing to deny treatment to certain kinds of patient on moralistic grounds, as some have suggested, is divisive and impracticable (e.g. what about the relatives of people who use legal or illegal drugs? who decides to what extent someone is responsible for their own health?) and anyway wouldn't solve the problem; NHS resources would still be limited, some drugs still too expensive.

John Stiles, Nottingham, England

I am about to go into a meeting at work - something that I would not be able to do if it were not for anti-TNF and other conventional drugs. I would be confined to bed and unemployed at the age of 49. I am one of the few thousand who suffer a very severe and aggressive form of arthritis. Without these drugs I would very quickly require expensive joint replacement surgery and other treatment to keep me living a life that wouldn't be worth living because of extreme pain in all my joints and tendons. I take pride in the fact that I am able to work full-time, support my family and contribute to the community in which I live. The authorities should take action in cases where a limited health budget is wasted in patching up drunks and druggies who arrive at every A&E in the country every weekend.
NICE also wanted to stop people being treated with more than 2 anti-TNFdrugs - I am on my third and this new drug, with a different mode of action, offered hope when the current drug stops working.

Norman Webster, East Grinstead,

This is an economic no-brainer. Rheumatoid arthritis is an agonising disease that reduces fit and productive young people to disability and dependence. I've had it for years and have only now been offered anti-TNF drugs, having repeatedly failed on older medications. Meanwhile, my joints have become more and more damaged and my pain unbearable. My GP doesn't even like prescribing decent pain relief because it costs money. Yet I've struggled to keep in work, pay full tax and NI and don't claim benefit. I've been so ill this year I was off work for months, and doubt I shall be able to continue without better treatment. I only wish a few politicians had this terrible disease - then they might realise it is a life sentence of agony. If NICE has it's way, one without parole. All treatment guidelines should take into account the cost of making patients unemployable and requiring full-time care if not treated appropriately.

Eve, London,

To Brian Lee
In the UK the NHS is not free. We all pay for it by tax from our salaries every month from the day we start working to the day we retire, whether or not we have need for it-National Insurance.

Reg , Reading, England

It is of course unreasonable to expect NHS coverage to provide for every treatment for every condition.

However, we should expect to know in advance what we are covered for, and to have an absolute right without regard to budgetary constraints to those treatments for which we are covered, if we fall ill with that condition.

The problem with the present situation is not that NICE will not approve abatacept. The problem is that even if NICE does approve it, it does not mean that we can get it. It will depend on where we live and what the state of the SHA budget is at the time we present. In short, what we are covered for and whether we get treated, and when, is a matter of the whims of 'managers'. It should be a matter of right.

This is little better than insurance fraud. It is a defined contribution, undefined coverage health care plan. The private sector would never get away with it.

Frederick DesLauriers, London, England

Arthritis sufferers are the genuine 'suffer in silence' brigade. It is an agonising complaint and I can only assume that those unNICE people who decided the drug is too expensive have no conception of this, or indeed know of anyone who suffers from arthritis. Once again, those of us who are being denied the drugs must wonder at the generosity of the Health Service in providing drug addicts with their drugs etc. etc.

Heather Thomson, Huntingdon,

What is the point of developing new drugs if they are not going to allowed to be used. because of cost. This seems to be another waste of money. Perhaps if NICE personnel were sufferrers the matter would be different.

Gillian Bayliss, Rhyl,

Could be worse . In the USA we have 48 million without any health insurance & drugs much more expensive here than in the UK. Think yourself lucky you have the NHS even with its failings its better than our system of medical greed . We have a great system for those that can afford it.

brian lee, medina, USA Ohio

Is this drug available on the NHS in Scotland. Is it only Emgland that is again denied?

Jack Taylor, Andover, hAMPSHIRE

I am presuming that this ban obviously only applies to patients in England, as health is devolved. And I also guess that the English tax payer will be funding this little goody for the Scots via the Barnett Formula.
I'm with Michael - we need a revolution!

Lynn, Ormskirk, England

Not a revolution - just an election. Unfortunately, though, all the mindless idiots that voted for Herr Diktator Blair will now vote for his successor. Will just one of you name ten positive acheivements of New Labour? Achievements, please, not unquantifiable spin.


Oh, and I don't count anything that involved meeting a target they had set for themselves.

Roger Tilbury, Worthing, England

Sadly, this drug and others like it will not be available tp suffers in the UK.

Our Prime Minister this week gave £100,000,000 to the UN for operations in Africa. This is in addition to the £6,500,000,000 already earmarked for International Development for the year 2007/8. (see Treasury website)

While Mr brown is prepared to assign figures like these at the drop of a hat then it will be at the expence of the young and old of our countrymen.

Nigel Graham-Miller, Valencia, Spain

As a suffererer of severe rh (as are many thousands of people in this country) I am appalled that the decision is to be taken not to trial this new drug. I have tried, through my doctor, most of the drugs available, including methotrexate and am aware of long term side effects of this particular drug and have always paid for my medicine through private insurance, which is extremely expensive.

It is disgusting when so much money from the tax payers in this country is being used to fight unnecessary wars, used to jet our Government officials, Prime Minister etc. etc., to "jollies" that sufferers not only from RA but other diseases, are not to benefit from perhaps a medicine which could give so much hope to thousands.

Marilyn Whittle, Buckinghamshire, United Kingdom

How ironic. The NHS are concerned about the cost of a drug that stops your joints getting so stiff. A few years ago they were concerned about the cost of a drug that had the opposite effect on your bone!

Rod Munch, Northampton, UK

Why don't we stop treating people for ailments caused by thier own choices, such as those caused by cigarrettes or alcohol, and direct this money to those who have real illnesses such as arthritis

jim , Motherwell,

It's time that we too are able to make our own generic copies of these medicines. If third-world countries can do it, so can we.

Health always trumps wealth. If all the big drug companies go bust, we can use our massive savings on doing the research and manufacture in the state sector, thus strengthening our research institutions and keeping our money in the country.

Vincent Murphy, London, UK

And yet, unneeded managers are not.

Farrukh, Woking, UK

N.I.C.E turns N.A.S.T.Y -[national association to scrimp on treating you]

misterp2, lower brailes,

What a bloody country! We can spend billions on Wars and ID Card schemes,but we deny the sick.
We need a revolution.

Michael J Rigby, Blackburn, England