The National Institute for Health and Clinical Excellence's likely decision to deny a new drug to NHS patients with rheumatoid arthritis has been described as a postcode lottery.
It is nothing of the sort: like free personal care for the elderly, it is another example of the benefits of political devolution. If you live in Scotland, that is.
Nice's rationale for denying the drug to NHS patients in England is that tocilizumab costs £9,000 a person a year and is therefore too high a price to pay.
Yet, over the border, the Scottish Medicines Consortium finds the cost perfectly manageable, which suggests its decision is influenced less by finances and more by patient care and comfort.
Only last July, a study by the National Audit Office showed that rheumatoid arthritis is more widespread than previously thought and is not being treated quickly enough.
The number of people with the condition is staggering - some 580,000 adults in England alone. One would assume the proportion would be similar in Scotland.
Moreover, the cost to the economy in sick leave and disability is £1.8bn a year
In 2006, the American College of Rheumatology reported on the long-term impact of rheumatoid arthritis on employment. Ultimately, the condition forces perfectly capable people to leave their jobs and pursue a life dependent on benefits.
It is why Nice must review its draft guidance, at least as it applies to moderate to severe cases. Sometimes money must come second. And sometimes England needs to look to Scotland for social policy direction.
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