Drugs cost watchdog urges review of new drug adoption
Britain’s drug cost watchdog has called for a review of the way new medicines are adopted in the NHS in the wake of criticism of its rejection of a series of expensive cancer treatments.
The National Institute for Health and Care Excellence said it wanted to draw the government, the health service, drugmakers and patient groups into a broad debate on access to new medicines.
Sir Andrew Dillon, chief executive of Nice, said the proposed review offered a chance for the pharmaceuticals industry to “reset” its relationship with the agency and the NHS.
One of the objectives would be to forge consensus on the NHS’s approach to expensive cancer drugs as the clock ticks down to the expiry in 2016 of a special £200m a year fund set up by David Cameron, prime minister, to pay for some oncology treatments rejected by Nice.
Nice has long been accused by some drugmakers and patient groups of setting too high a bar for life-saving medical innovation in its assessment of which products offer value for money to the NHS.
But Sir Andrew said he sensed a willingness on the part of industry to work with Nice on developing new models for drug pricing and appraisal that encouraged uptake of new medicines without busting the health budget.
“Most companies recognise the economic reality of the NHS because that’s their market,” Sir Andrew told the Financial Times. “Any commercial enterprise needs to understand the capacity of its market to purchase their products.”
He proposed the creation of an “office for innovation” within Nice that would work with companies during the drug development process to help them provide the evidence needed to demonstrate value.
He said the review should also look at new ways of “sharing risk” between drugmakers and the NHS – which could involve more flexible “performance-related” pricing that would rise or fall depending on how effective a new medicine turned out to be.
The proposals, endorsed by the Nice board on Wednesday, came after a six-month consultation on how the agency could adopt more “value-based” methods for assessing new medicines.
The consultation had been demanded by the Department of Health as it looks for ways to control the £13bn a year spent on pharmaceuticals in the face of rising prices for breakthrough drugs.
However, Nice said that the 900 opinions it received from 121 organisations were too divergent to come up with recommendations.
Instead, Sir Andrew said he would seek the government’s backing for a more wide-ranging review of “innovation, evaluation and adoption” of new treatments.
Drugmakers argue that Nice’s rejection of many new medicines – particularly for cancer – is undermining government efforts to promote the UK as a place to invest in life sciences.
Roche of Switzerland said last month that Nice was “no longer fit for purpose” after blocking its Kadcyla breast cancer drug, which typically extends life by about six months at a list price of £90,000.
While vowing to work with drugmakers, Sir Andrew said it was “essential that industry also recognises its role in making innovative treatments available to people at a fair price”.