Healthcare executives from around the UK voiced strong support for the economic value of medicines to modern society at the 18th annual PharmaTimes Great Oxford debate last week.

A large majority agreed with the motion ‘This house believes that medicines deliver net savings to the nation’, while 69 voted against it, following a lively debate in the world famous Oxford Union debating chamber which saw convincing arguments delivered by both sides.

Proposing the motion, Professor Sir Michael Rawlins, chairman of the National Institute for Health and Clinical Excellence, argued that even allowing for factors such as side-effects and expense medicines deliver savings in both wealth and health.

In support of his position, Sir Michael listed a catalogue of achievements in recent history – such as the development of antivirals to help people live longer with HIV, and the revolution in psychiatric care that has enabled scores of patients to lead ‘normal’, productive lives – that have made a valuable contribution to society. “We don’t need a sophisticated economic model to see medicines have delivered massive savings”, he stressed.

Sir Michael was seconded by Martin Mackay, president of global research at AstraZeneca, and supported by Sir Alasdair Breckenridge, chairman of the Medicines and Healthcare products Regulatory Agency.

Mackay pointed out that the increase in life expectancy from 1970-2000 alone has doubled GDP in the US, which he said can largely be attributed to medicines, while Sir Alasdair spoke of achievements in the near future, particularly with the advent of personalised medicines, that will help to further boost the efficacy and cost-effectiveness of new therapies and thereby presents new opportunities to deliver even greater savings to the nation.

Opposing the motion, Lord Norman Warner, former Minister of State, Department of Health, conceded that medicines have delivered many benefits and saved lives, but that this has come at a price. “This motion is not about past glories, but whether the right balance is being struck now”, he said, arguing that currently the cost of new medicines increasing but their value is shrinking.

Lord Warner noted that while millions of pounds and considerable human talent is sunk into new drug development every year, a significant number of therapies coming onto the market fail to offer an improvement on existing ones, and he stressed that the NHS drugs’ bill is rising faster than GDP.

Benefits questionable

Also opposing the motion, Professor Ken Patterson, Chairman of the Scottish Medicines Consortium, said the magnitude of treatment effect is not being assessed properly and benefits of medicines to the National Health Service and patients are often questionable. “We are indulging in population polypharmacy in the hope of treating a small number of patients”, he said.

According to Patterson, a quarter of medicines assessed by the SMC in the last nine years offer no benefit above existing therapies, while only 9% offered a cost saving. “New medicines are over-hyped, over-sold, over-priced and frequently do not represent value to the NHS”, he argued.

Professor Nick Bosanquet, Head of Health Policy at Imperial College London, said current healthcare policies are guided by nostalgia into irresponsibility because of the lack of evidence available, and he stressed the need for a different way forward with more accountability for the value of drugs.

See next month’s PharmaTimes Magazine for a full report on the debate.