Drugs access varies across England

New data published today shows widespread variation in patient access to drugs approved by the National Institute for Health and Clinical Excellence (NICE) at primary care trust (PCT) level in England.

The data, published by the NHS Information Centre, from the Metrics Working Group, compared predicted and observed use of 47 NICE-approved medicines in the NHS. The Metrics Working Group comprises representatives from the Department of Health (DH), Association of the British Pharmaceutical Industry (ABPI) and NICE.

In this, its second report, the group has collected PCT and cancer network data as well as information at strategic health authority (SHA) level, enabling a more detailed investigation into the medicines patients are being prescribed.

The report provides an important step towards clear, transparent evidence to help identify, understand and break down barriers to consistent national access for NHS patients.

Director general of the ABPI, Dr Richard Barker said: "What is clear from this data is that you need to look at a local level to see what medicines patients are really getting access to. With some of the medicines at national or SHA level usage data looks fine, but the picture looks quite different at the PCT level.

"This report is still very much work in progress, but it raises some serious questions for healthcare providers and makes the case for clear national guidance as we move towards a new era in local decision-making in NHS commissioning.

"Recent reports repeatedly show the UK continues to lag behind other Western European countries in the uptake of most innovative medicines despite having among the lowest prices. So price is obviously not the only factor in patient uptake: we need to understand the other factors that influence what patients receive."

The report, 'Use of NICE-appraised medicines in the NHS in England - 2009, Experimental statistics', considered 47 new medicines in 18 groups, relating to 29 technology appraisals.

Some of the biggest regional variations were shown in uptake of medicines to treat diabetes and osteoporosis at PCT level.

The report looks at insulins to treat diabetes and shows observed usage varies from 65 per cent less than predicted by NICE to 95 per cent higher than predicted.

When comparing the observed use and predicted use of six NICE-approved medicines to treat osteoporosis, the variation is even greater with the lowest usage being 79 per cent less than expected and the highest 632 per cent higher than expected.

The data collection was agreed as part of the 2009 Pharmaceutical Pricing Regulation Scheme. The report does not interpret data, but provides an insight into what is happening so that healthcare providers, industry, patient groups and Government can pinpoint why and where variation is happening and develop solutions.

The report enables PCTs to compare uptake of NICE-approved medicines across England and provide a more accurate measurement against NICE expected uptake.  

The NHS Information Centre has the report available for download.