A few weeks ago, I blogged about how we currently price medicines in the UK and how this might change in the future. I made clear which elements the pharmaceutical industry would like to see retained from the existing arrangements and suggested that value-based assessments be incorporated in to the next pricing scheme. But this vibrant debate continues to progress and I thought it would be worthwhile to now address some of the latest thinking on the subject.
One of the key talking points at the moment is how can we design a pricing system that encourages greater uptake of innovative medicines. Many contest that a greater emphasis on assessing medicines according to their value would naturally lead to more new medicines being used in the NHS. I’m not sure this would actually be the case. There are many other factors which effect uptake in the healthcare system, such as a clinical conservatism, systemic challenges and fiscal constraints. I think these areas need to be addressed first, otherwise we could end up completely redesigning the pricing system at great expense, to find exactly the same problems of uptake remain.
In fact, I believe a further layer of complication in the form of value-based assessments of medicines, could inadvertently become another hurdle to medicines gaining access to the market because of the time and complexity involved in assessing their value. For NHS patients this could mean a longer wait for innovative new treatments.
To address one last point, some commentators are currently discussing how the sale of medicines can better match market dynamics. In other words how can we create a system that means as medicines are sold at a greater volume, there is a corresponding fall in price. In some ways though, I think this misses the point and implies, falsely, that we need prices to fall because they are currently too high in the UK. This is not the case. UK prices are amongst the lowest in Europe, and we spend 0.9 per cent of our GDP on medicines – less than the European average of 1.2 per cent.
In short, the pharmaceutical industry is already delivering good value to the NHS – see our 10 key facts on the cost of medicines. If changing the price-volume dynamic would genuinely improve uptake then it should be looked at more closely, providing the related practicalities can be resolved. But we need to be clear that UK medicines are not expensive and it is important to note that companies actually have their profits capped across their whole portfolio of medicines.
My preference remains for a pricing scheme that is flexible, holistic, negotiated in a single agreement and which rewards research and development, so new treatments can be found for unmet clinical need. I believe a system that delivers these elements will be in the best interests of patients and our industry.
ABPI Chief Executive