The UK’s drug cost watchdog is calling for a review of the way in which new drugs are adopted, evaluated and taken up by the NHS.
This review needs to involve patients, people working in or with the NHS, the life sciences industries and healthcare researchers, says the National Institute for Health and Care Excellence (NICE), in its response to a consultation on how it currently evaluates new drugs. The review should be part of any changes made to NICE’s current methodology, the Institute adds.
The six-month consultation, on proposals to regularise NICE’s decision-making process through value-based assessment, has produced no agreement among the more than 900 opinions received from 121 organisations and individuals, and it is clear that just changing NICE’s methods will not overcome concerns about how the NHS accesses new treatments, said the Institute’s chief executive, Sir Andrew Dillon.
“We also need to look at other processes, including the model of pharmaceutical R&D, the expectations that companies and patient groups have about how risk and reward is shared between the industry and a publicly-funded NHS, and in the arrangements for commissioning expensive new treatments,” he said.
Alongside any changes to its methods, NICE is also proposing:
- an office for innovation inside NICE to provide companies with a “flight path” through the stages of the development, evaluation and adoption of their products into the NHS;
- agreement between NICE, the Department of Health and NHS England on the NHS’ willingness to pay for new treatments, which would take account of any special cases, such as cancer and ultra-orphan conditions; and
- more productive sharing of risk between companies and the NHS. The aim would be to progressively reflect the value of new treatments as knowledge of what they can offer to patients increases; NHS England’s “commissioning through evaluation” process could be used for this.
“There have been exciting changes in R&D of new medicines and other health technologies which is increasingly challenging all those involved in brining new treatments to patients. This requires a wider review of the NHS’ arrangements for supporting innovation and evaluating and adopting new treatments,” said Sir Andrew. He added: “and it’s essential that industry also recognises its role in making innovative treatments available to people at a fair price.”
- The life science industry and patient groups each made up approximately a third of the 121 organisations and individuals which responded to the consultation. Most of the rest were from academics and clinical/professional organisations.