

Refund for defective drugs
Drug manufacturers have said they will refund the NHS if their patients do not respond to a new drug for bone marrow cancer.
The National Institute for Health and Clinical Excellence is recommending multiple myeloma patients in Wales and England should get Velcade on the NHS.
Initial draft NICE guidance recommended the drug should not be made widely available on the NHS, but after an appeal by the manufacturer and its suggestion of a refund scheme, the watchdog changed its mind.
Drugmaker Janssen-Cilag has said the NHS should only pay for the drug which costs about £18,000 per patient, if it works.
In clinical trials, Velcade has been shown to slow, halt or even reverse the progression of multiple myeloma.
Under the terms of the NICE recommendation, patients who show a full or partial response to the drug should be kept on it and treatment paid for by the NHS.
But if patients show little or no response to the drug, they should be taken off it and the NHS should be refunded by the manufacturer.
The final decision on whether to put the refund scheme into practice rests with the manufacturer and the Department of Health, with final NICE guidance expected in October.