Treatments with an estimated cost of up to £10,000 per QALY (quality adjusted life year) - well within NICE's cost-effectiveness limit - will now be dealt with quicker under a ‘lighter touch’ process.
NICE currently considers drugs that cost up to £20,000 to £30,000 as within the acceptable cost-effectiveness range. But the fast-track system will see the institute publish final guidance on 'exceptional value' treatments immediately after they receive their license.
They will therefore receive funding from NHS England within 30 days of NICE’s recommendation, rather than the current 90.
A new ‘budget impact threshold’ of £20m per year has also been proposed to ‘better manage the introduction of treatments that are deemed cost-effective, but have a very high cost’.
This threshold will enable NHS England to try to negotiate ‘commercial agreements’ with drug companies to manage overall costs. Rules requiring NHS organisations to introduce treatments backed by NICE within 90 days could also be relaxed in these cases.
Sir Andrew Dillon, NICE chief executive, said: ‘We want to be more agile and flexible in the way we make decisions about new drugs, medical devices and diagnostics, so that patients can get access to them more quickly and the NHS can manage its resources fairly and efficiently. NICE and NHS England have worked together to develop these proposals.
‘The pace and scale of innovation in the NHS require NICE and NHS England to collaborate closely to ensure patients are benefiting from faster access to the most cost effective treatments.
‘By further streamlining our processes we will ensure treatments that clearly offer exceptional value for money will be available to the patients who need them faster than ever before.
‘NICE and NHS England believe these proposals represent a fair approach to the significant challenge of providing faster access to innovative, cost effective treatments alongside the need to safeguard future financial sustainability. I would urge anyone with an interest in these issues to let us have their views before the consultation closes on 13 January 2017.’
Dr Jonathan Fielden, NHS England’s director of specialised commissioning and deputy national medical director, said: ‘Our proposals also provide clarity, for the first time, that the NHS is prepared to pay far more for effective highly specialised treatments appraised by NICE.
‘These treatments, for patients with very rare conditions, will now qualify for automatic funding at a level that is five times higher than NICE's current limit. On top of this there will also be the added flexibility to negotiate with drug companies on those technologies which are cost effective but have a heftier price tag.’