Acupuncture no longer recommended for back pain

NICE (the organisation that provides guidance to doctors in the UK) recently updated their recommendations regarding lower back pain. In the updated guidance, they say that exercise, in all its forms (for example, stretching, strengthening, aerobic or yoga), is the most important step in managing back pain.

Previously, NICE also recommended acupuncture or massage, but this has now been altered. Massage can still be used alongside exercise, but the guidelines no longer recommend acupuncture, as “evidence shows it is not better than sham treatment”. Continue reading

The cost of a cancer breakthrough

MelanomaA new combination of drugs marketed by Bristol-Meyer Squibb has been hailed as a breakthrough in cancer treatment. Almost every media outlet carried a story about the results of a trial that were announced at a conference in Chicago yesterday, with the usual hype. The results are quite remarkable. 58% of metastatic melanoma patients treated with this new drug combination saw their tumours shrink, with the tumours stable or shrinking for a median of 11.5 months. This is amazing when you consider that metastatic melanoma was thought to be largely incurable as recently as 5 years ago.

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Why are some drugs not provided on the NHS?

NICE cancer drug decisions
NICE cancer drug decisions

The decision not to provide a drug on the NHS can have a devastating impact on patients and their families, and often causes a negative public reaction. However, therapies are getting increasingly expensive (particularly cancer therapies) and NHS has a very limited budget. As a result, in spite of the impact on patients and public opinion, 36% of cancer drugs evaluated since the start of 2014 (see pie chart) have been rejected, usually on the basis of cost. Continue reading