Monday, December 16, 2013

NICE must get tougher on pharma, urges BMJ journal

Published on 16/12/13 at 08:34am

NICE image

The UK should have one universal health technology assessor which should seek to tighten up rules on whether new drugs become available for NHS funding.

This is according to an entry in the journal Drug and Therapeutics Bulletin (DTB) which is part of the BMJ Group, and says that NICE would ‘do well’ to take a leaf out of its sister organisations’ books in Wales and Scotland.

DTB argues that between 30% and 40% of all new drug appraisals in the three countries have to be jettisoned, because the manufacturer in question has failed to supply the evidence needed to make the case for the drug.

But unlike Scotland and Wales where this situation usually prompts a recommendation for the drug to be rejected for use in the NHS - this is not the case in England, where such decisions are usually left up to the discretion of the local decision-making bodies.

This leads to “the inevitable duplication of effort and the potential for postcode availability”, it says.

“We believe that England should follow the example of Scotland and Wales and not support use of a medicine when the company does not comply with the submission process,” it contends.

While the appraisal processes in Scotland and Wales cover most new drugs and licensed indications for treatment, this responsibility largely falls to the more than 200 local clinical commissioning groups across England.

DTB also suggests that it might be more efficient and economical if just one UK body was responsible for evaluating the clinical and cost-effectiveness of new drugs, given that all three bodies will be reviewing the same data.

“It could be argued that in a time of financial austerity, it might be more economical to run a single UK appraisal service to supply the same information to each appraisal committee (national or local),” it says.

Twenty years ago the NHS general practice drug bill came to £2.6 billion a year - now those same costs have quadrupled to more than £10 billion a year, the authors say.

DTB points out that during this time, however, the systems for evaluating the financial and clinical benefits of drugs have ‘vastly improved across the UK’ - but warn that these organisations “shouldn’t be resting on their laurels”.

Ben Adams

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