NICE Sets Prices Too High, But Lowering Them Could Hinder New Treatments

The NHS agrees to pay too much for new medicines and the National Institute for Health and Care Excellence (NICE) has set its price threshold too high, research from the University of York claims.

Researchers said the high price paid for medicines causes more harm than good – in particular, the special cancer drugs fund is poor value and diverts money from other patient services.

Responding to the analysis, NICE said that lowering prices could force the NHS to limit the availability of newer treatments, the costs of which must be balanced against investments in to routine care.

NICE sets price limits using a measure called quality-adjusted life years (QALY) which weighs the cost of using a drug for a year against how much someone's life can be extended or improved. At present, costs of over £20,000 to £30,000 per QALY are not considered cost-effective.

Researchers at York say the level should be closer to £13,000 to provide the NHS and its patients with the most benefit.

Study co-author Professor Karl Claxton said of the findings: "The increasing pressure to approve new drugs more quickly at prices that are too high will only increase the harm done to NHS patients overall."

However Sir Andrew Dillon, chief executive of NICE, said: Unless you think that drug companies will be prepared to lower their prices in an unprecedented way, using a threshold of £13,000 per QALY would mean the NHS closing the door on most new treatments."

Expert Opinion

This research has raised very serious questions regarding the current system in place related to access to drugs and it is vital that the concerns raised are carefully considered by the NHS, NICE and the Government. <br/> <br/>"We often see first-hand the impact that problems regarding access to NHS treatment can have on patients, often leaving people in a difficult situation if they are unable to receive the treatment their doctor would like to prescribe for them. <br/> <br/>"If they cannot, there is the option of bringing a legal challenge against their NHS trusts or any national scheme to secure vital drugs and health treatments. We’ve been involved in a number of cases where this has been an issue, including helping those who sought access to the breast cancer drug Herceptin and also helping others to try and access the eye drug Lucentis. <br/> <br/>"It is vital that amid all of the debate regarding access to drugs and treatments, the needs and safety of patients is not forgotten." Yogi Amin - Partner