Abstract

In the zero-sum game of allocating resources within a national health service, difficult decisions must be made, and initial guidelines issued by the UK National Institute for Health and Clinical Excellence (NICE) have once again provoked strong feelings among researchers, clinicians, campaigners and patients. NICE has recommended against funding for Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) in the treatment of metastatic renal cell carcinoma, judging that the improvement in progression-free survival does not justify the high cost of the treatment.