New drugs would be denied to the elderly under harsh plans by ministers who want to prioritise patients who contribute to the economy, the NHS treatments adviser has warned.
The National Institute for Health and Care Excellence (NICE) has rejected plans to take "wide societal benefit" into account when considering whether to pay for a drug, as part of a shake-up in how funding should be allocated to patients.
Under an appraisal system, NICE will also have to take into account the cost of medication and its life-enhancing properties.
But health experts have warned that vulnerable groups such as the elderly may lose out because they do not contribute as much to society as younger people.
Sir Andrew Dillon, the head of NICE, said that he was uncomfortable with a "fair-innings approach" that would discriminate against the elderly.
He said: "This wider societal impact is such a sensitive issue. You can do it in a hard-nosed economic way, which is the department's calculation, but our sense is the wider public see wider societal impact as being more subtle than that. And we're really concerned that we don't send out the message that we value life less when you're 70 than we do when you're 20."
NICE warned drugs that helped middle-aged men would be judged as having more social value because they earn most, whereas a drug helping people to live longer in an expensive care home would have a negative social impact because such patients take more from society than they can put back.
Mr Dillon added: "What we don't say is those 10 years you have between 70 and 80, although clearly you're not going to be working, are not going to be valuable for somebody. Clearly they are. You might be doing all sorts of very useful things for your family or local society. That's what we were worried about and that's the problem with the Department of Health calculation.
"There are lots of people who adopt the fair-innings approach: 'you've had 70 years of life you've got to accept that society is going to bias its investments in younger people'. There are people who subscribe to that but it's not something we feel comfortable (with)."
Sources close to Jeremy Hunt, the Health Secretary, insisted that the proposal was at an early stage and that he would intervene if the elderly were being discriminated against.
The Department of Health said: "We have asked NICE to look at the way drugs are assessed so that patients can get the treatments they need at the best value for the NHS, and the price the NHS pays is more closely linked to the value a medicine brings. We understand that it's an important and complex issue, on which many people will have views and NICE will be consulting widely on the proposals."
Ciarán Devane, chief executive of Macmillan Cancer Support, said: "The UK has some of the worst cancer survival rates in Europe and they are especially bad for older people. Macmillan strongly recommends against any action which could make this worse. The NICE board is right to reject the Department of Health's proposal."
The draft policy is to be released for consultation within the next few weeks.