Pall T. Onundarson: Anticoagulation Guidelines Under the Influence of Pharmaceuticalisation
Pall T. Onundarson, Professor Emeritus of Hematology at University of Iceland, shared a post on LinkedIn about a recent article by John Abraham et al., published in Sociology of Health and Illness, adding:
“Corruption in British healthcare systems is described in this interesting British sociological study about ‘biomedicalisation’ and ‘pharmaceuticalisation’ using the case of oral anticoagulants as an example, written by John Abraham (University of Brighton and Sussex, UK) and Gowree Balendran (Keele Universtiy, Newcastle, UK).
They don´t object to new drugs or innovation – but in the case of OACs argue that warfarin should have been made first choice and DOACs a second line choice – and that outside influence, namely money, led to the NICE guidelines favoring DOACs over warfarin.
The study argues that NICE may actively promote novel drug ‘pharmaceuticalisation’ through permissive regulation, industry influence, expert conflicts of interest, and an emphasis on patient choice and innovation over cost-effectiveness.
They refer to evidence suggesting that this approach can produce a net loss in population health by diverting NHS resources from more cost-effective treatments.
The authors recommend strengthening independent cost-effectiveness assessment, restricting pharmaceutical industry involvement and conflicts of interest on clinical guidelines, and protecting NICE’s independence from commercial and political pressures.
They warn that raising cost-effectiveness thresholds under the UK–US trade agreement risks further prioritising pharmaceutical innovation over public health.”
Title: Inside the ‘Black Box’ of Pharmaceuticalisation: NICE, the Permissive Principle and the Case of Anticoagulants
Authors: John Abraham, Gowree Balendran
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