You're claiming that this is a limit for treatment and that this is maximum amount the NHS will spend per patient. That's simply untrue.

Yet again: that figure is the negotiation amount used by the NHS when dealing with companies designing meds to be sold into the NHS. It has nothing at all to do with how much the NHS will spend per patient per year.

The cancer drugs fund is useful: the first version had to be scrapped because it was spending billions of pounds on new meds that were fantastically expensive but didn't extend life, nor improve quality of life, and which often made QoL worse or shortened life. https://www.newscientist.com/article/dn26785-the-uks-cancer-...

> But I cited specific sources for the median insurance reimbursement of glioblastoma being over $180,000

You're doing a few things here. 1) You're implying that US treatment is good, and 2) you're insinuating that people in the UK aren't going to be treated for glioblastoma because the cost is greater than the NICE guideline for cost of treatment.

1) https://www.nice.org.uk/guidance/ta121/chapter/4-Evidence-an...

> The Assessment Group reported that the Food and Drug Administration (FDA) in the USA expressed several concerns when it evaluated the trial. There was an imbalance between the types of tumours in the study arms, which could have favoured carmustine implants. The FDA requested a review of histological diagnoses and a sensitivity analysis was performed using diagnoses by an alternative pathologist. A further concern was that the manufacturer's analysis treated death as an event when measuring time to progression. A reanalysis was performed of the data on the time to progression as determined by decline of neurological symptoms and performance status, with deaths being censored. In addition, the manufacturer's analysis of the overall survival data included stratification by country, and the data were reanalysed without stratification. The data reported below relate to the unstratified analysis unless otherwise stated. [...]

> There was no difference in progression-free survival between treatment groups. Median time to progression was 5.9 months (95% CI 4.4 to 8.3 months) in the carmustine implant group and 5.9 months (95% CI 4.7 to 7.4 months) in the placebo group (using stratified analysis). The manufacturer's analysis suggested that both the time to decline of KPS score and the time to progression on neurological indices were statistically significantly improved (that is, increased) in the carmustine implant group. The FDA reanalysis of these data found that there were no statistically significant differences in these measures of progression-free survival and that the differences resulted from variations in survival times between the treatment arms.

> [...] The effect of temozolomide on the quality of life of patients was investigated in the largest RCT using a cancer-specific quality-of-life questionnaire. Of seven preselected scales, the only statistically significant difference between treatment groups was in social functioning at the first follow-up during adjuvant treatment with temozolomide (in favour of the radiotherapy alone group).

US treatment gives people brain damage, decreases quality of life, doesn't do much to increase length of life, and then because the US doesn't negotiate drug prices costs a lot of money. In the US with its expensive treatment we still see that the five year survival rate on less than 10%, that the average life expectancy is only 8 months, and that these very expensive treatments (which can severely degrade QoL) extend life by maybe a couple of months. Remember, these aren't months when you're walking around living normal life, they're time spent in hospital. Regret rates for cancer treatment ("I wish I didn't have that treatment, I wish I'd done something else") are very high.

2) It's simply untrue to suggest that people in England[1] don't get treatment for gioblastoma. They do get treatment. What does happen is that they don't get ripped off for meds.

https://bnf.nice.org.uk/drugs/carmustine/medicinal-forms/

> Carmustine NHS indicative price £5,203.00 (Hospital only)

https://bnf.nice.org.uk/drugs/temozolomide/medicinal-forms/

> Temozolomide 250 mg NHS indicative price £814.00 (Hospital only)