The question of cost "hardly arose" when making the decision to advise doctors not to prescribe zanamivir (Relenza) for NHS patients, says Professor Sir Michael Rawlins (chairman, the National Institute for Clinical Excellence).
In a letter to The Times on January 11, he writes that the advice was based on three elements: First, that the drug is only likely to reduce influenza symptoms by one day "in the real world"; secondly, that the efficacy of Relenza in people at special risk has not yet been established - a fact acknowledged, he says, by company prescribing literature; and thirdly, that, in the absence of clear benefit, "it would have been irresponsible for the institute to propose that Relenza should be available during the busiest time of the general practitioner's year".
He concludes that any suggestion that treatment of the elderly has no value because they represent a financial burden to the country is "as untrue as it is horrid".