The National Institute for Health and Care Excellence has urged pharmaceutical companies to question the development costs of new medicines.

The call comes in a letter to The Times newspaper from NICE chief executive Sir Andrew Dillon, responding to a comment piece by the newspaper’s business editor, Ian King, which warns that unless NICE stops restricting access to drugs because they are too expensive or have too many harmful side effects, the industry will stop developing drugs in the UK.

Sir Andrew replies: “I suspect that the research and clinical environment here holds too many advantages for companies to do that, though it is certainly the case that there is a global market for life sciences R&D and the UK has to compete hard to win its share.” 

Mr King’s article quoted Pfizer UK’s managing director Jonathan Emms, who wrote in The Times Online that it now costs £1.2 billion to bring a new medicine to patients.

“19 out of 20 attempts fail before they reach the patient – even before any NICE review,” added Mr Emms, who urged the government to examine the way NICE makes its decisions “to ensure innovation is better recognised and used.”

“NICE is blocking the innovations that scientists are discovering. Last year it turned down 40% of new medicines, telling the NHS that it cannot use them or restricting use. In doing so, NICE is denying patients access to some of the best treatments available today,” says Mr Emms. 

Commenting on the £1.2 billion development figure quoted by Mr Emms and reported by Mr King, Sir Andrew says that this cost “seems to go up each time it’s estimated,” although he acknowledges that it “clearly is expensive to develop new drugs.”

“Companies are entitled to expect a return on their investment, but health services have to be confident that the extra benefit to patients justifies the price. It mostly does so, through sometimes at a stretch. If we are not sure, we have to say so, in the interests of all those of us who expect the NHS to apply its resources equitably across of the demands we make of it,” he writes.

And, he says: “if it really does cost £1.2 billion to develop a new drug, the question the pharmaceutical industry must be able to answer is this: are you absolutely confident that it needs to?”