Well, the UK has DEATH PANELS (as some people call them) which is probably the National Institute for Health and Care Excellence (they had a name change which makes the acronym a bit weird, but their still called NICE).

So if a medication can't show efficacy and is very expensive it's not going to get NHS funding.

We used to allow people to spend their own money if they wanted to on medication. We still do - IVF has limited provision as one example - but there was a spate of drug companies releasing very expensive and not very efficacious meds. When they got turned down for NHS funding those companies paid money to patient groups to campaign for changes in the decision. (Pretty fucking sleazy - using the desperation of dying people to promote your ineffective medication) The government at the time decided to change the rules around a small number of medications. You would be able to buy those yourself, but you would then have to pay for the rest of your care too. I'm not convinced that was the right decision.