In December, you may have noticed that 'The Times' ran a news piece on the ABPI’s continued concerns about the latest medicines being rejected for use in the UK. The article highlighted the case of pirfenidone, a medicine researched and developed for the chronic lung disease – idiopathic pulmonary fibrosis (IPF). This disease kills 5,000 people every year in the UK and there are currently no effective treatments and there have been no therapeutic advances in this area for decades. Yet just recently this medicine was provisionally rejected by NICE for use in the NHS and is one of many medicines which were denied approval in 2012.
This is deeply frustrating, let me explain why. Firstly, medicines in the UK are not expensive – we have amongst the lowest priced treatments in Europe. What’s more, as a proportion of the NHS budget, medicines spending has been declining and forecasts show that as a proportion of overall NHS expenditure, spending on new medicines is actually set to shrink. Yet despite medicines expenditure being well under control, many of the newest and most innovative treatments continue to be rejected. This is doubly frustrating when you consider that the research and development of medicines is hugely expensive and risky, and companies need to make a return on their investment for new research to be conducted. In short, companies are having to make investment decisions in a deeply uncertain environment, despite the low prices of the medicines they sell to the NHS.
Secondly, and more importantly, the medicines rejected by NICE could make a real difference to the health of many thousands of people living with a disease. But the implications of blocking a medicine stretch even further because we are stopping innovation in its tracks. The history of medicines shows us that treatments generally begin by making only a modest impact on a disease, but over time, small incremental improvements to the original product give us a medicine which ends up completely transforming the way we treat a condition. NICE must realise this and understand that their continued rejection of new medicines could be standing in the way of breakthroughs in battling disease.
In 2013 we need a more pragmatic approach from NICE that takes into account unmet clinical need and a realisation that medicines will save the NHS money in the long run by keeping people healthier, for longer.
ABPI Chief Executive