Showing posts from August, 2007

Donepezil: Nicely done NICE. What about the gap in affordability though?

The National Institute of Clinical Excellence (NICE) has been bolstered by a recent Court decision and is beginning to flex its powers of rationing. Dobbs J sitting in the English High Court heard an appeal by way of judicial review from a decision of the appeal committee of NICE. [1] In a 139 paragraph judgement given on 10 th August 2007 he decided that NICE: had the power to issue guidance declaring the use of Donepezil (an anticholinesterase inhibitor that has proven benefits for patients suffering from Altzheimer’s disease) to lack cost-effectiveness in patients with mild to moderate disease and; had not been irrational in its approach nor procedurally unfair in the way it had reached it’s decision. The appellant ( Eisai Limited) was merely a consultee in the process and had been treated appropriately by NICE during the evaluation process. NICE’s victory was not complete. It had a duty in relation to ensuring that its guidance complied with anti-discrimination laws. In i

Asymmetric morality is one key to victory in asymmetric warfare

On the 10 th of May 2007 General Petraeus made 3 things clear in a letter about values : 1. The war in Iraq is about securing the population of Iraq. This means more than providing them with personal safety and a secure environment in which to live. It also means winning the battle for their hearts and minds. 2. The way to secure that population, in both senses, is to uphold important human values particularly respect for human dignity. 3. Personal integrity must require that the captured enemy prisoners are treated in accordance with the rules applicable to any detainee. For the American Army this is Field Manual 2-22.3: Human Intelligence Collector Operations . The key to this is to understand that if you sacrifice your values you become no different from your enemy. If the population cannot distinguish you from the enemy you are doomed to defeat in the battle for their hearts and minds. But victory in this sphere is critical because the physical war is being fought with as