Many students look at health care spending and rationing decisions when they cover the introductory concepts of opportunity cost, scarcity and the cost benefit principle. In this recent BBC Newnight report, the decisions taken by the National Institute for Clinical Excellence (NICE) - the organisation that decides whether treatments are cost-effective enough to be purchased for patients by the NHS. Cancer drugs especially those that provide targeted medicine for a small patient population can carry a very high unit cost per patient and this is taken many of these drugs above the level that NICE will allow, even though some of these drugs so make a significant difference.Should cancer drugs be taken out of the NICE cost benefit calculation or should drugs companies make more effort to lower their prices?