On 7 January 2015, the National Institute for Health and Care Excellence (NICE) issued a draft clinical practice guideline on the management of type 2 diabetes by the NHS in England and Wales. The Association of the British Pharmaceutical Industry (ABPI) welcomes the opportunity to respond to the draft guidelines.
The ABPI agrees overall with many elements of the draft guideline including the need for patient-centred care; the importance of weight loss and dietary management; and recognition of the detrimental impact of hypoglycaemia on a patients’ quality of life.
However, we share the concerns of the diabetes community that the section on ‘Blood Glucose Management’ is fundamentally flawed.
The ABPI is disappointed with the recommendations in the ‘Blood glucose management’ section of the guideline and requests that NICE revises this section, including the glucose-management medicine algorithms.
The ABPI believes that the guideline is potentially too heavily focused on achieving short-term cost efficiencies, at the expense of individualised patient care. It appears fundamentally inconsistent with NHS England and the Department of Health’s medicines optimisation agenda and runs counter to NICE’s own guidance and focus on promoting high-quality care within the NHS. Given the commitments from NHS England to support the uptake of innovation, we find it surprising that the draft guideline does not include the latest NICE reviewed medicines that have been subject to NICE technology appraisal. The apparent focus on crude drug acquisition costs will set back NHS clinical practice.
The draft guideline does not reflect current NICE’s own Single Technology Appraisals Guidance (TA315, TA151, TA288, TA248, TA53, TA203, TA60, TA274, TA301), nor does it evaluate the newer diabetes medicines have not been through NICE TA review. It also runs counter to the patient-centric approach of the well-established and respected joint guideline recently issued by the European Association for the Study of Diabetes (EASD) and American Diabetes Association (ADA), as well as common and established clinical practice in the UK.
ABPI calls on NICE to fundamentally revise the glucose-management medicine algorithm detailed in the draft NICE type 2 diabetes clinical guideline so that it clearly supports clinicians to deliver an individualised patient-centred care approach to type 2 diabetes management for NHS patients fully in line with the requirements of medicines optimisation.
The ABPI represents innovative research-based biopharmaceutical companies, large, medium and small, leading an exciting new era of biosciences in the UK.
Our industry, a major contributor to the economy of the UK, brings life-saving and life-enhancing medicines to patients. Our members supply 90 per cent of all medicines used by the NHS, and are researching and developing over two-thirds of the current medicines pipeline, ensuring that the UK remains at the forefront of helping patients prevent and overcome diseases.
The ABPI is recognised by government as the industry body negotiating on behalf of the branded pharmaceutical industry, for statutory consultation requirements including the pricing scheme for medicines in the UK.
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