NICE: new system will allow more drugs on NHS

pharmafile | February 17, 2014 | News story | Sales and Marketing DH, Dillon, DoH, NHS, NICE, QALY 

NICE has said that it will be able to approve more medicines under a new drug pricing policy, but warns that this will have the inevitable effect of increasing the patented drugs bill.

This is according to the British newspaper The Times which interviewed NICE’s chief executive Sir Andrew Dillon this week.

Sir Andrew told paper that he wants to use a similar calculation to its quality adjusted life years (QALY) formula to assess how much patients’ quality of life is affected by their illness, and use this to estimate the social benefit of a treatment that could restore them to full health.

NICE will now begin a consultation on its alternative approach, which Sir Andrew says “makes it much easier to identify the features of a drug that will allow [us] to say yes”. He said: “[It] gives us the opportunity to see if there’s any more benefit we can squeeze out of the treatments we look at in terms of the knock-on effects they might have for society.”

More drugs would be also approved under an alternative formula that would give extra weighting to patients’ quality of life, NICE added.

Sir Andrew said he was “absolutely confident that it’s not going to result in fewer treatments being approved” and said that about six of 20 recently rejected cancer drugs might have been approved by the new formula, which is likely to increase the NHS drugs bill.

The Department of Health said in statement: “We have asked NICE to look at the way drugs are assessed so that patients can get the treatments they need at the best value for the NHS, and the price the NHS pays is more closely linked to the value a medicine brings.

“We understand that it’s an important and complex issue, on which many people will have views, and NICE will be consulting widely on the proposals.”

Wider societal benefit

This all comes as NICE looks to implement new plans from the government in the way it assesses medicines. Earlier this year a new value-based assessment deal was approved by the government that aims to change the way in which the NHS pay for drugs.

One of the major new elements could be allowing through medicines that have a ‘wider societal benefit’ – but there has been much debate on exactly what this entails.

Sir Andrew told the paper that he was uncomfortable with a ‘fair-innings approach’ that could take funding away from the old because younger patients had more to gain from treatment and more to give back.

The government has been at pains to say that implementing a wider societal benefit to drug assessment will not affect the elderly – the largest demographic in terms of NHS drug spend.

But an internal assessment of the plans by NICE found that “any approach to wider societal benefit will inevitably take age into account to some degree” and it was ‘conceptually difficult’ to reconcile the plans with the NHS commitment to equal treatment.

Drugs that helped middle-aged men would be judged as having the greatest social value because they earn the most, NICE warns. A medicine that helped people to live longer in an expensive care home would have a ‘negative’ social value because such patients take more from society than they can put back.

Sir Andrew told The Times: “This wider societal impact is such a sensitive issue. You can do it in a hard-nosed economic way, which is the [Department of Health’s] calculation, but our sense is the wider public see wider societal impact as being more subtle than that. And we’re really concerned that we don’t send out the message that we value life less when you’re 70 than we do when you’re 20.”

Ben Adams 

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