Opinion on the new drug pricing scheme and value-based assessment remians negative after a PharmaTimes snap poll showed just 13% considered the PPRS good for patients and 61% believing VBA will not improve access to medicines.

The results come as part of an audience poll taken after a PharmaTimes meeting discussing the mechanics and implications of the new Pharmaceutical Pricing Regulatory Scheme and proposed value-based assessment.

Eric Low, chief executive of Myeloma UK, berated the lack of patient consultation during the negotiations, adding that patients are the biggest losers under the scheme because they won’t be able to access the drugs they want. “I understand why the industry is the prime negotiator but do I trust that they have patients’ interests at heart? I would say no. This idea that it’s good for patients is window dressing because there are too many vested interests.”

For Low, a big problem is that regardless of the new PPRS there will still be hurdles to accessing drugs – namely the constraints imposed on clinicians to prescribe. “It might take 10-20 years to change the culture of prescribing. There is nothing in the PPRS that will change that. We’re a long way off from the aspirations of the PPRS to improve outcomes and access.”

Another concern raised was the problem around innovation. Vincent Lawton, former managing director and vice president Europe of MSD and former ABPI president, said he had been “excited” to learn about the inclusion of innovation “but realised there was nothing in the wrapping” when reading further. “We have the slowest uptake of new medicines in the civilised world. It will be difficult to maintain our place in innovation if no one will take them up. There are no incentives in the scheme that I can see,” he said. Indeed, 45% of the audience believed investment in the UK will fall as a result of the PPRS.   

Societal impact

An ongoing debate in the media of late has been the discussion around the new value-based assessment proposal – the consultation of which will be due out in the next couple of weeks – and how this may negatively affect certain sectors of society, such as the elderly. According to our snap poll, just 2% thought VBA will have a positive effect on the elderly, with 41% believing the effect will be negative.

This is despite NICE’s shift away from the Department of Health’s approach of wider societal benefits – calculating the consumption and production of resources – which the Institute feels uncomfortable accepting because of the implications, Meindert Boysen, NICE’s programme director, technology appraisals, told the meeting. Instead the Institute is proposing incorporating wider societal impact, which does not involve an economic calculation, as a criterion under VBA.   

Wider societal impact works by quantifying the extent to which people are able to engage with society as a result of having a condition compared to not having the condition. As such, appraisal committees would value technologies based on their potential to restore the ability of individuals to engage in society. “If we have to do anything, this is perhaps the best way of doing it rather than by economic ways,” Boysen said.

What this meant for the industry, he added, was that the experience of patients on the drug would become increasingly important as part of the HTA process.

Moving forward, Low also believes future PPRS negotiations will be much more open and public as there will be the need to include other stakeholders such as patients in the process.

 What are your views on the new PPRS and proposed value-based assessment? Let us know, anonymously if you want, and we will look at printing these in the April issue of PharmaTimes Magazine. Email newsdesk@pharmatimes.com to let us know your thoughts.