As more health systems around the world move towards using clinical and cost-effectiveness assessments of drugs and medical products in order to ensure they produce value for money, the UK can lead the field, regulators and industry experts have forecast.

The kinds of Health Technology Assessments pioneered by the UK’s National Institute for Health and Clinical Excellence are going global, with initiatives being explored in Europe and Scandinavia, plus Australia, Scandinavia and even the USA, said Peter Littlejohn, director of clinical and public health at NICE, addressing the Institute’s annual conference in Birmingham yesterday.

Richard Tiner, medical director at the Association of the British Pharmaceutical Industry, agreed that there are real opportunities for the UK to lead in the development of HTAs worldwide, and pointed out that the nation has already pioneered a number of ground-breaking health initiatives, such as the introduction of clinical trial registration.

Industry relationships "fertile"

Dr Tiner said the UK industry’s research relationships with NICE and the National Health Service were “very fertile and positive,” and that Sir David Cooksey’s newly-published report on publicly-funded health research in the UK offers “all sorts of opportunities for industry and NICE to work together.” However, he stressed the importance of not simply focusing on the UK. NICE covers England and Wales, while the UK industry is global and increasingly regulated from Europe, he said, and called for discussion in areas where the industry might not always be able to deliver on what NICE wants.

There needs to be a global approach to harmonisation of HTAs, as has been achieved in clinical trials by the International Conference on Harmonisation (ICH), said Dr Tiner. This view was supported by Tony Whitehead, medical director at sanofi-aventis and a member of the NICE R&D Advisory Committee. While the ICH had initially been dismissed as a “talking shop” and its processes had taken a very long time, they had achieved an enormous amount, he said. However, Dr Whitehead warned that, in taking a global view of HTAs, assessing value for money is not the same as the pricing and reimbursement negotiations conducted between industry and governments around Europe, which are characterised by “horse-trading” and political discussions. By Lynne Taylor