Sunday, March 11, 2007

Second lung cancer drug not made available to NHS patients

Another new cancer drug has been rejected by the Government's value-for-money watchdog. Roche, the healthcare company that makes Tarceva, used to treat lung cancer, said that it would appeal against the decision by the National Institute for Health and Clinical Excellence (NICE), which it said was perverse and disappointing. It claimed that the evidence Roche presented had been assessed "neither fairly nor appropriately" by NICE. Tarceva has been approved for use in Scotland since June 2006.

The NICE guidance said it did not believe that Tarceva (erlotinib) was the best use of resources in the care of sufferers of non-small cell lung cancer. It said that the drug would be reviewed again next year. Andrew Dillon, chief executive, said: "After considering all the evidence available, as well as the comments received during consultation on the earlier draft, the independent appraisal committee concluded that erlotinib is not an effective use of NHS resources when compared with either docetaxel or best supportive care. The committee was also concerned that erlotinib would not be as effective as the existing standard treatment, docetaxel.

"However, given the rapidly changing evidence base for erlotinib, the committee advised that the guidance should be considered for early review. Therefore this guidance will be reviewed in February 2008. "The committee also recommends that further research be undertaken into subgroups for whom erlotinib may provide greater benefit." Subject to an appeal being received, final guidance to the NHS is expected in April.

Mike Unger, chief executive of the Roy Castle Lung Cancer Foundation, said: "We are obviously severely disappointed and disillusioned with NICE's decision not to approve Tarceva purely on economic grounds. It's the second blow that NICE has dealt to lung cancer patients in a month, following the announcement to decline Alimta - so there are now very few options left for lung cancer patients."

Mr Unger added: "This leaves massive inconsistencies in treatment options for lung cancer patients in the UK. It's absurd that Tarceva is available to certain patients in Scotland, but not the rest of the UK. Tarceva is used as a standard treatment in many other European countries and this should be the case here." Tarceva has been hailed by the medical profession as a big advance in a neglected area of cancer.


Gun law and common sense

Comment from Britain by Peter Hitchens

More rubbish is written about 'gun control' than about almost any other subject. Allegedly 'tough' gun and knife laws are the liberal substitute for the death penalty, the left's way of trying to stop criminals from killing. Like most 'liberal' solutions, they don't work against their intended target, and they attack freedom. It helps a great deal to be liberal about this if you a) don't think about it and b) know no history at all. Until 1920, Britain's gun laws made Texas look effeminate. There was no effective restriction at all on owning a firearm. Yet there was virtually no gun crime. Now we have some of the most restrictive anti-gun laws in the world, and gun crime is a serious and growing problem. Interestingly, the laws came first, the problem afterwards, and the recent ban on handguns was a completely logic-free response to the Dunblane mass-murder which preceded it.

Here's a strange fact. If you read the Sherlock Holmes stories, you will notice just how frequently Holmes and Watson take guns out on various missions (Watson’s is usually his trusty old service revolver, retained from his brush with war in Afghanistan). On one occasion, Holmes amuses himself by picking out the Royal monogram 'VR' in bullet-pocks above the fireplace, a remarkable tribute to his shooting ability with a handgun. His skills may have been exceptional, but gun ownership was, at the time the stories were written, entirely legal and normal, and nobody thought it odd.

What is strange is that modern British readers of these stories never pause to wonder how and why things have changed so much. Well, if you do wonder, I must direct you once again to the relevant chapter of 'A Brief History of Crime' in which I was accused of arguing that we should all carry weapons about, as one female acquaintance of mine generally does in the State of Virginia, perfectly legally.

British leftist feminists, who warn constantly that all men are rapists, and endlessly demand harsher punishments and looser rules of evidence in rape prosecutions, really ought to be keen supporters of America's 'Second Amendment Sisters', who argue that women should all be armed and dangerous, and rapists, as a result, should be mostly dead, or too afraid to try it on. But somehow, they aren't. One liberal obsession clashes with another, yet again....

The same 'experts' who have banned guns and knives (with no noticeable effect on their use by criminals, though the harassment of innocents for carrying pen-knives grows year by year) pursue individuals for hitting burglars too hard or, in a notable incident last week, a pensioner who had clouted one of a gang of youths who had pelted his home with snowballs for hours on end. And they are wholly ineffectual in dealing with burglars on the rare occasions when they both catch them and manage to prosecute them.

Yet the one thing that will bring a rapid and powerful police response to a phone call is a claim that guns are being used by private citizens. And the one offence the courts will always punish severely is the one they call 'taking the law into your own hands'. Why? Because they are much more worried about their monopoly of force than they are about protecting us. Is that a good sign?

Actually, I object strongly to the expression 'taking the law into your own hands'. The law is ours and we made it for ourselves, to protect us and govern us, as a free people. Our freedom to defend ourselves against criminal violence is part of our general freedom to live our lives lawfully. We hire the police to help us enforce the law, not to tell us that we cannot do so. Sadly, the modern British law is not our law, but an elite law, based on ideas which most of us do not share. And the modern police are the elite's police, not ours, which is one of the reasons why they have vanished from the streets, where we want them to be. The disarming of the people, and the cancellation of all their rights to defend themselves, are bad signs.


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