The UK's NICE is soon to lose its "superpowers" when it comes to rejecting new medicines for use on the National Health Service (NHS) plan. NICE will be reduced to an advisory role only - doctors will make the final treatment (i.e drug access) decisions.
The UK will now move to so-called value-based pricing. Under this new system, drug company prices will be largely based on scientific evidence of value in clinical practice. Theoretically, decisions will be less pure cost based (current limit is about $34,000 in UK) and will take into account value delivered for the cost spent. See Pharmalot.
NICE's former powers to exclude drugs have been blamed by consumer groups for dismal cancer survival rates in UK and a lot of untimely deaths. New cancer drugs were frequently rejected by NICE due to their high costs -- even if clinically effective according to its critics. NICE defended this practice by saying that left more to spend on other conditions.
Now the government will attempt to drive pharma companies to prove their drugs are cost effective and clinically effective -- and will deliver value. The idea is to get drug companies to bring forth their drugs capable of proving their worth. Otherwise, more marginal drugs, that are expensive too, will be restricted to limited groups of patients where no better option exists. NICE will likely die after a suitable transition period.
Posted by Bruce Lehr November 2nd 2010.