Today’s front page story in the Daily Telegraph “Patients are denied high cost drugs by NHS trusts” raises new concerns about an on-going problem – how to improve patient access to new innovative medicines in the NHS.
In the UK, we have among the lowest medicines prices in Europe, and rigorous health technology assessment processes which assess the clinical and cost effectiveness of new medications to determine whether they represent good value for money for the NHS. Yet too often, we hear of patients being denied the best medicines even when they have been approved for NHS use by health technology agencies such as NICE.
Interestingly this story makes the headlines on the same day that surgeons highlight the long-term cost-effectiveness and value for money of using gastric bands to tackle the increasing problem of obesity in the UK. It seems perfectly logical that if one procedure can help prevent the development of weight-related diseases such as diabetes, thereby improving the health and quality of life for patients whilst saving the NHS money in the long run, that this is the right way forward for all.
And yet when it comes to new innovative medicines, the debate about value seems to get lost. Of course industry must demonstrate the value in medicines, but after that patients must be able to access that value in a timely manner. We need to talk more about investment, not just the investment that industry makes in researching and developing new medicines, but also the investment in health and the longer-term savings to the NHS. Even incremental medical advances can mean reduced hospital admissions and an improved quality of life whereby patients may be able to live more independently, perhaps even returning to work, which can also take pressure off family, friends and carers. These are the sort of wider societal benefits that need to be taken into account when decisions on prescribing are being made. In some cases they are but it is not happening across the board.
The NHS Constitution clearly sets out that patients have a legal right to receive a medicine approved by NICE if they are eligible to receive it and a mandatory direction on PCTs requires within three months of a medicine being approved by NICE that funding must be made available. These two measures still apply even in the rapidly evolving NHS environment.
This is one of the reasons why we continue to work with the Department of Health and the NHS to improve the evolving relationship between industry and healthcare professionals. With greater mutual trust and collaborative working that keeps the focus firmly on patients’ clinical needs we can change things and ensure that patients can receive the medicines they need when they need them. It is in all our interests to do so, making “black” or “red” lists a thing of the past.
Dr Paul Catchpole, ABPI