NICE expects patient access schemes to remain a feature of the UK’s pricing landscape after the introduction of value-based pricing (VBP).
Both new and existing patient access schemes are likely to have their place within the UK’s new pricing system once it comes into effect in January 2014, according to NICE’s deputy chief executive Professor Gillian Leng.
But there remains some uncertainty about the schemes, which effectively see pharma companies offer deep discounts in order to reach the cost effectiveness thresholds the National Institute for Health and Clinical Excellence (NICE) demands.
Speaking at the INSEAD Healthcare Alumni Summit 2012 in London last week Prof Leng said that, although the exact fate of patient access schemes was still uncertain, they were likely to remain due to the predicted small number of drugs that will undergo VBP in its early stages.
She also noted that VBP will only apply to new entities, meaning existing schemes are unlikely to be removed.
Negotiations on how VBP will work only began last month system, but the system, which will replace the current Pharmaceutical Price Regulation Scheme (PPRS), is set to overhaul how new medicines are priced.
The 2009 PPRS placed a stronger emphasis on patient access schemes, which are proposed by pharma companies and agreed directly with the Department of Health, either on a straight financial basis or with a focus on outcomes, where prices can be re-negotiated if a drug proves its clinical value.
A total of 25 drugs have now been recommended by NICE thanks to a patient access scheme, while Novartis’ eye drug Lucentis has just received a draft recommendation in diabetes macular oedema after agreeing to part-fund its use.
The introduction of patient access schemes has also led to a sharp decline in appeals from pharma companies regarding NICE decisions, Prof Leng noted.
She said 31 per cent of appraisals were appealed in 2008, before the schemes were launched, whereas in 2009, 2010 and 2011 the percentage that resulted in appears was 11 per cent, 18 per cent and 17 per cent respectively.