Also in the press
ACADEMICS TO CALL FOR NICE'S COST-EFFECTIVENESS THRESHOLD TO BE LOWERED
The Financial Times reports on Wednesday that academics are to urge NICE to lower the threshold below which it considers medicines to be cost-effective and therefore recommended for use on the NHS (p3).
According to the FT, research from York University, due to be completed next month, will call for NICE's cost-effectiveness threshold to be lowered from around 30,000 pounds to 20,000 pounds per quality adjusted life year (QALY).
The academics speculate the threshold could fall as low as 10,000 pounds but do not say under what circumstances this might happen.
The York research expands on earlier work that concluded the average cost per QALY of approved drugs for a number of major diseases, including cancers and circulatory problems, is below 20,000 pounds.
Although the research team from the Centre for Health Economics has no formal policy role, their findings are likely to be influential as their study was commissioned by the publicly funded Medical Research Council, which works closely with NICE and the Department of Health, the paper continues.
The report's recommendations come at a time when the NHS is seeking sharp budget reductions to cope with a fall in government funding, according to the article.
Findings are likely to fuel debate between those who consider new drugs consume a disproportionate amount of the NHS budget and those in the pharma industry who believe it should be rewarded for innovative new treatments, the paper says.
Deepak Khanna, UK managing director of Merck, Sharp and Dohme, and president of the Association of the British Pharmaceutical Industry (ABPI) trade body, says in the article: "We would be very concerned if the cost-effectiveness threshold was lowered from the current level as it would significantly reduce the number of new medicines being approved for use on the NHS."
Professor Karl Claxton, lead recipient of the research grant at York university, disagrees, saying: "Manufacturers with a patented drug have an incentive to price right up to whatever threshold is in place."
NICE has no formal legal threshold but has been increasingly open about using 30,000 pounds per QALY as its upper limit for approval, although it has accepted some drugs above the threshold and rejected some below it.
However NICE's status is under threat because of plans to introduce value-based pricing for drugs, although mechanisms are still being debated, the FT notes.
Khanna tells the paper: "It is our view that the current threshold should in fact rise so that the UK can begin to catch up with our European counterparts on uptake of medicines and to spur further investment in research and development.
"At the very least, the threshold needs to remain at the same level to stop patient care moving backwards in the UK."
The article summarises costs per QALY for four drugs - Novartis' Lucentis (ranibizumab) for wet age-related macular degeneration (16,000 pounds per QALY), Johnson & Johnson's Simponi (golimumab) for arthritis (27,000 pounds), Bristol-Myers Squibb's Baraclude (entecavir) for hepatitis B (14,000 pounds per QALY) and Elan/Biogen Idec's Tysabri (natalizumab) for multiple sclerosis (35,000 pounds per QALY).