Pharma companies should not regard cost-effectiveness evidence requirements as a burden; rather, they should seize them as an opportunity to re-engineer and align their R&D with real-world market access, says National Institute for Health and Care Excellence chief executive Sir Andrew Dillon. 

It is “absolutely critical” for industry to recognise the fiscal realities now facing the NHS, and to work with the NHS as it reviews new products and help it make good judgements about how to use them, Sir Andrew told a recent Westminster Health Forum (WHF) seminar. “And when we all agree we have something really good, help the NHS make the business case for adoption,” he advised industry delegates.

Defining value in health is a complex proposition, with multiple perspectives, including those of users, payers, suppliers and government, said Sir Andrew. “We say it’s all about the patient, but we also know it’s also about what drives us – success for our organisations, however that’s defined.”

But, he added: “some ambitions we can share. The motivation behind what we do should be about achieving the best outcomes with the resources available, and we should be honest about the opportunities and limitations of the system, the people and the technologies - we need to share an openness about this.”

And: “we need to do the things we know work, do them safely and well, and do them consistently.”

On average, the NHS takes two to three years to adopt NICE recommendations, the meeting heard.  How to improve this take-up is “complicated, because the NHS itself is complicated – sometimes the system is just waiting for permission to do something,” said Sir Andrew.

And while poor take-up can be due to a variety of issues – fiscal barriers, lack of ambition or leadership, for example – there are currently no incentives for take-up, and we need now to concentrate on designing these into the system, he said.

NICE’s work in helping the development of innovative new treatments includes providing companies with product-specific confidential advice through the Scientific Advice Programme, in conjunction with the regulator when requested.

It is also working with industry on developing new methods to “fully tease out” the value proposition for products, and contributing to European Union (EU) initiatives aimed at speeding up the delivery of effective new treatments – “but remaining aware that we are always working on behalf of the NHS,” Sir Andrew told the meeting.