News / MPs fear for drugs affordability

A scheme to increase access to expensive medicines could become unaffordable as pharmaceutical companies target new drugs on small groups of patients with rare diseases, MPs have warned.

In its response to cancer tsar Professor Mike Richards’ review on top-up payments, the Commons health committee said the government had come up with two initiatives to increase the availability of expensive drugs to NHS patients – a renegotiated pharmaceutical price regulation scheme and guidance from the National Institute of Health and Clinical Excellence (NICE) giving its appraisal committees greater flexibility when assessing end-of-life treatments.

The MPs were concerned that the latter – which effectively raised the cost-effectiveness threshold – was inequitable and an inefficient use of resources.

‘By spending more on end-of-life treatments [for rare conditions] for limited health gain, the NHS will spend less on other more cost-effective treatments,’ the report added.

The committee said NICE must clarify its definition of small populations – groups of patients with rare conditions (normally no more than 7,000 new patients a year) – to which the new guidance applied. It said the current definition was ‘too woolly’ and, with new drugs increasingly aimed at smaller subgroups of patients, the scheme could become unaffordable.

The committee was concerned proposals for separating NHS and private treatment would be hard to achieve in practice and patients’ quality of life would be disrupted just to meet bureaucratic niceties – inappropriately moving a patient to a private ward to administer a drug that had been paid for privately, for example.