According to the UK’s Department of Health, the National Institute for Health and Clinical Excellence (NICE) will no longer be able to reject new medicines destined for use in the National Health Service (NHS). Instead, GP groups will decide whether a drug will be funded under value-based pricing plans set to come into effect in 2014.
NICE will still provide advice on medicines’ effectiveness, however. NICE chief executive, Andrew Dillon, said he was supportive of moves to extend access to treatments at prices reflecting additional value to patients. He anticipated NICE would be ‘at the heart’ of the new plans.
Health Secretary Andrew Lansley explained that the aim was to give patients confidence that when NHS doctors believed a particular drug was the right and most effective one for them, the NHS would be able to provide it.
From 2014, GP consortia will be allocated money from a total of over £70bn to spend on all healthcare services in their areas.
Responding to the announcement, Dr Richard Barker, director general of the Association of the British Pharmaceutical Industry (ABPI), told PMLiVE.com: “Improving patient access to new life-saving and life-enhancing medicines, as consistently as possible, must be the top priority. The NHS only gets value from new value-adding medicines when they actually reach patients.
“We agree with Government that it is important to set quality standards for the new era of GP-led commissioning and we welcome the involvement of NICE in this process. The ABPI believes that this expansion of NICE’s remit to promote clinical best practice is a higher priority for the future of the NHS than the overly narrow cost effectiveness calculations on new medicines it currently conducts.
“The 2009 Pharmaceutical Price Regulation Scheme (PPRS), which the Government has committed to until 2014, already contains elements of a value-based approach, including patient access schemes and flexible pricing. We will be actively engaged in a review of these elements over the coming months.
“It is too early to speculate on what the new value-based approach will look like, as the devil will certainly be in the detail. We expect NICE to be involved in the process, with a broader definition of value, but do not envisage it being a price-setting authority. We look forward to co-creating the scheme with the Government over the next few years.”
Mike Hobday, head of policy at cancer charity Macmillan Cancer Support, said: “NICE has performed a really important role for the NHS. Having a body that can say ‘no’ to pharmaceutical companies has been crucial in driving the price of drugs down, so that the NHS can afford to support patients more often. But NICE has too often misread the public mood in rejecting clinically effective drugs for rare cancers. It has placed insufficient weight on the importance of allowing the NHS to give patients with rare cancers the drugs that their doctors believe will extend or improve the quality of their lives.
“We are talking to the Government to ensure that, when NICE is reformed, the NHS will provide all cancer patients with access to clinically effective drugs recommended by their doctors,” he concluded.
However, some critics suggest that whoever is in charge of funding for new drugs, the budget is finite and not everyone will be able to have what they want. There are also fears in some quarters that the ‘postcode lottery’, where particular drugs may only be available in certain areas, will be perpetuated.