NICE price pressure will reduce drug availability

Commercial pressures being put on drug companies by NICE are reducing the availability of drugs for UK patients, experts fear.

The criticism follows a draft technology appraisal for bortezomib (Velcade) for multiple myeloma, which was published last week.

The NICE appraisal recommends that, if patients show minimal or no response, they should be taken off the drug and manufacturer Janssen Cilag should refund the costs.

If patients show a complete or partial response, the NHS will foot the bill, providing the recommendation is included in the final guidance due in October.

A single course of bortezomib will cost an average of £18,000 per patient.

According to NICE, this is a way for NHS patients to try expensive new drugs and see if they work for them.

But GPC prescribing subcommittee chairman Dr Peter Fellows branded the scheme ‘crazy’.

‘All that will happen is that the drug will be priced to pay for the pharmaceutical company’s research and development,’ he said.

Pressure put on pharmaceutical companies by NICE and the push for GPs to prescribe generic versions of medicines where possible were likely to lead to a rise in individual drug costs, explained Dr Fellows. In turn, NHS patients are even less likely to receive them.

‘Already we are seeing that new drugs are cheaper in Europe than they are in this country,’ he added.

A report published last month showed that the UK lagged behind the rest of Europe in the use of new cancer drugs and cancer survival rates (GP, 15 May).

A spokesman for the Association of the British Pharmaceutical Industry said: ‘NICE’s health technology assessment programmes aren’t flexible enough.’

The House of Commons Health Select Committee is currently investigating the role of NICE, including the increasing challenges being made against NICE decisions, the evaluation process, public confidence and implementation of technology appraisals and clinical guidance.

ater this month, NICE will face a judicial review over its decision to restrict use of cholinesterase inhibitors to those with moderate to severe Alzheimer’s disease.

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