Patients in the UK are being penalised by a regulatory environment that slows down the uptake of new medicines and makes doctors reluctant to prescribe them even if they are backed by the National Institute for Health and Clinical Excellence (NICE), the country’s cost-effectiveness watchdog.
That is the view of the Association of the British Pharmaceutical Industry (ABPI), which published a manifesto last week aimed at increasing the uptake of innovative new drugs and tackling the problem of "postcode" prescribing under the National Health Service.
New figures produced by the ABPI show that the UK still lags behind its European and global counterparts in prescribing new, innovative medicines for patients. Even five years after their launch, major cancer medicines are still being prescribed at under two-thirds the rate of other, comparable countries; diabetes medicines at under half the rate; and dementia medicines at about one-third.
At the same time, ABPI statistics show that the medicines bill declined last year and, while a modest growth is estimated for this year, it will be well below previous growth rates. Prices of medicines are expected to continue to decline in real terms.
"There is a serious short-changing of British patients. Health care and medicines are all about patients and, in the UK, they are not getting modern medicines as quickly as they should, and often not getting them even when NICE has said they should," said Nigel Brooksby, president of the ABPI.
The ABPI figures show that, in the UK, new medicines - those no more than five years old - have an uptake more than 25% lower than the average in comparator countries.
Of 18 new drugs launched in this period, 13 are being prescribed below the rate of other countries, with nine at less than 50% of the usage rate elsewhere. New cancer drugs have just 64% of the overall take-up, according to 2005 figures. The glitazones for diabetes, have 63% usage of comparable nations three years from launch, and dementia treatments some 30%.
The increased take-up of medicines following a positive recommendation by the NICE should be prompt and substantial - but the ABPI says its figures show that this is not the case, noting that prescribing of medicines for cancer, diabetes and Alzheimer's disease often shows little or no change following the Institute's approval.
The overall medicines bill is not to blame, insists the ABPI, noting that it dropped by an estimated 3.8% in 2005, following the imposition of the 7% price cut under the terms of the new Pharmaceutical Price Regulation Scheme. Looking forward, prices are expected to drop in real terms, and the increase to the budget caused by new products will be small, it says.
For its part, the UK Department of Health is forecasting an increase in hospital spending on drugs next year, and believes pharmaceutical spending will grow 12.5%, or by around £390 million ($740m). The new appraisals and NICE guidances (which include recommendations on non-medicines) will add a further £150 million to hospital spending, it said.