NICE VS. Not-So-NICE: A Nasty Squabble Over Reimbursement
Will drugmakers abandon the UK because the national reimbursement gatekeeper is too strict? In a recent opinion piece, Ian King, the business editor at The Times of London, warned the pharmaceutical industry will abandon drug development in the UK unless the National Institute for Health and Care Excellence rolls back its practice of restricting access to drugs based on expense or side effects.
His essay quoted Pfizer (PFE) UK managing director Jonathan Emms, who wrote in his own piece that “NICE is blocking the innovations that scientists are discovering. Last year, it turned down 40 percent of new medicines, telling the NHS that it cannot use them or restricting use. In doing so, NICE is denying patients access to some of the best treatments available today.” He adds that it costs 1.2 billion pounds, or roughly $1.9 billion, to bring a new drug to patients, but that 19 of 20 attempts fail.
Not surprisingly, NICE ceo Andrew Dillon did not agree. In a letter to the paper, he contends that the “research and clinical environment (in the UK) holds too many advantages for companies” to abandon the country, although he concedes that a global market requires the UK to “compete hard to win its share.” And he goes on to justify the NICE decision making process. The agency, he notes, is chartered with providing the National Health Service the best medicines available at affordable prices.
His essay quoted Pfizer (PFE) UK managing director Jonathan Emms, who wrote in his own piece that “NICE is blocking the innovations that scientists are discovering. Last year, it turned down 40 percent of new medicines, telling the NHS that it cannot use them or restricting use. In doing so, NICE is denying patients access to some of the best treatments available today.” He adds that it costs 1.2 billion pounds, or roughly $1.9 billion, to bring a new drug to patients, but that 19 of 20 attempts fail.
Not surprisingly, NICE ceo Andrew Dillon did not agree. In a letter to the paper, he contends that the “research and clinical environment (in the UK) holds too many advantages for companies” to abandon the country, although he concedes that a global market requires the UK to “compete hard to win its share.” And he goes on to justify the NICE decision making process. The agency, he notes, is chartered with providing the National Health Service the best medicines available at affordable prices.
“Companies are entitled to expect a return on their investment, but health services have to be confident that the extra benefit to patients justifies the price. It mostly does so, though sometimes at a stretch. If we are not sure, we have to say so, in the interests of all those of us who expect the NHS to apply its resources equitably across all of the demands we make of it. NICE is, quite properly, scrutinised closely on its decisions and the methods we use to arrive at them. We have changed and improved over the decade and more that we have been advising the NHS. We are not perfect, but we are respected throughout the world for the quality of our work.
However, Dillon also pokes Emms just a little by retorting that, while it is clearly expensive to develop a new drug, the cost cited by industry “is a number that seems to go up each time it’s estimated… If it really does cost 1.2 billion pounds to develop a new drug, the question the pharmaceutical industry must be able to answer is this: Are you absolutely confident that it needs to?”STORY ENDS HERE
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