NICE warns over cost scrutiny in value-based pricing plans

NICE has backed the proposed value-based pricing scheme for medicines but warned that plans to reward innovation could waste NHS resources.

In a response to the recent DoH consultation, NICE chief executive Sir Andrew Dillon welcomed proposals for the NHS to pay prices for drugs that reflect therapeutic benefit.

But the institute warned that its role scrutinising effectiveness, and the legal right to access recommended treatments, must be retained to avoid worsening postcode lotteries in drug access in times of fiscal constraints.

NICE also said it was ‘very concerned’ about plans to vary thresholds for assessing the cost effectiveness of new drugs.

Under the plans, the DoH will determine cost effectiveness thresholds for new drugs based on burden of illness or unmet need. But NICE said decisions must strike a balance to ensure use of new products ‘does not deprive other patients of cost effective care’.

Rewarding innovative new drugs will lead to double counting of benefit, which will already have been captured in the cost effectiveness assessment, it added.

‘This will lead to poorer value for money and less efficient use of NHS resources compared with the current arrangements,’ it said.

Sir Andrew said: ‘We also share the government's ambition to ensure that the option exists for all new licensed drugs to be offered to those patients who can benefit from them, provided the price is a fair reflection of their value,’ he said.

NICE is set to play a prominent role as the primary advisory body under the plans, although the DoH said the details will depend on the outcome of the consultation.

It said it welcomes the opportunity to appraise drug benefits under the scheme if implemented. Sir Andrew said the aims of the plans could be achieved by adapting the existing NICE process.

‘We are confident that the government will want to take advantage of NICE's expertise and experience as it develops value-based pricing.’

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