A call by UK politicians for all new medicines to be assessed at launch by the National Institute for Health and Clinical Excellence, and at a lower cost-per-quality-adjusted life year (QALY) threshold than the £30,000 which NICE generally sets for a full assessment, does patients a “grave disservice,” an industry spokesman has warned.

Such a “worrying” development “would mean patients in the future having an even tougher time of getting the medicines they need, when they need them,” David Fisher, commercial director of the Association of the British pharmaceutical Industry, told a meeting in Parliament this week, which was organised by PharmaTimes to discuss early reactions to the House of Commons Health Select Committee’s report into NICE, issued on January 10.

The Scottish Medicines Consortium does examine all new drugs at launch and, by and large, it comes to the decisions as NICE as to which treatments should be made available on the National Health Service, except the SMC does it one or two years earlier, Health Select Committee chairman Kevin Barron told the meeting.

However, Mr Fisher pointed out that, following an SMC assessment, the Scottish Health Boards then decide their own guidance on the treatment’s use and warned: “we must guard against SMC blight.”

Opportunities not problems
NICE should begin its deliberations not from the point of view of a problem to solve but an opportunity to treat more patients, said Mr Fisher. In the industry’s view, the Committee report should have put more emphasis on implementation of NICE guidelines, he said, and suggested that the “very impressive” tools and processes which the NHS has developed to help ensure national targets are met should also be used to encourage the local prescribing of treatments which NICE and the SMC have recommended that patients should be offered.

On pricing, the MPs' report agreed with the Office of Fair Trading and the government that “better mechanisms are needed to ensure that the NHS pays a fair and affordable price for medicines,” and said that NICE should be involved in any new system set up to achieve this. However, Mr Barron (Labour, Rother Valley) told the meeting that it seems unlikely that the UK government will adopt the OFT’s recommendations, made a year ago, that the Pharmaceutical Price Regulation Scheme (PPRS) should be replaced with a system of value-based pricing (VBP). Talks to renegotiate the PPRS are currently underway between the government and industry.

- A fuller report on the meeting will appear in the March issue of PharmaTimes Magazine.