The National Health Service is failing to take into account what patients really value, particularly societal costs, when it comes to medical treatments, claims a new report by centre-right think thank for health and technology 2020Health.
The group is currently working on a project entitled How to Improve Patient Outcomes from New Medical Treatments – Can Value-Based Pricing Help, and its claim is based on findings from a survey which revealed that “a huge majority” of respondents think the NHS ignores patient opinion.
“The NHS must understand what patients truly value; the gulf of opinion between healthcare recipients and healthcare providers harms the patient’s wellbeing, medicine’s progress and the nation’s economy,” said Julia Manning, Chief Executive 2020health. “The NHS says it is patient centred; it must be patient centred,” she stressed.
The group points out that while the new Pharmaceutical Price Regulation Scheme includes an appraisal by the National Institute for Health and Clinical Excellence of the value of medicine, which the Office of Fair trading believes could save the NHS around £500 million a year, it argues neither the NHS nor NICE has consulted with stakeholders on how they value medical therapies.
A public consultation by 2020Health found that there is a “large disparity between what the NHS ‘values’ and what patients, clinicians, medical company managers and other stakeholders ‘value’”, and while issues of effectiveness and safety came in at the top, dignity, care needed from friends and family and time away from work were also cited as “hugely important” by patients, project leader Ginette Camps Walsh explained.
Sir Ian’s rejection
However, this is in direct contrast to recommendations made by Sir Ian Kennedy earlier this year that societal benefits should not be included in NICE’s treatment appraisals process.
Sir Ian insists that benefits such as easing the burden on carers and allowing patients to work should not be considered because they would represent “a hard-to-justify bias in favour of those capable of working and being productive, as against children and the elderly”. In addition, he warned against the “privileging of those who are heard as against those who are not – NICE exists to weigh the interests of all patients, not merely those who make their cause known”.
But he also acknowledged the case for incorporating at least some social values in NICE appraisals, and so has called for more research into the area to help determine whether this is at all feasible.
2020Health’s final report, which the group says will identify how to remove barriers to the effective uptake of new treatments and patient access schemes, is due out next year.
