What if drugmakers didn't have to lobby National Institute for Health and Clinical Excellence to be accepted by the U.K.'s state health service? And what if the much-vaunted NICE no longer had the power to decide whether a company's meds are worth the price?
The NHS is about to undergo "a root and branch reform," and experts say it will be the greatest reorganization of the service since it was set up in 1948, InPharm reports. As part of the plans, NICE will lose its drug-gatekeeper status, making it into an advisory group rather than a yea-or-nay agency. The agency will still make recommendations, but those decisions won't be binding. Instead, the body will focus on quality standards, according to InPharm.
The U.K.'s new coalition government doesn't want to deal with the sort of controversies NICE decisions could create, InPharm reports. Just think about the pricey cancer drugs the agency has rejected over the last couple of years; every nay from NICE caused a public outcry. The new government has even set aside £50 million to pay for cancer treatments NICE had barred.
NICE's hard line has lately inspired drugmakers to offer discounts and risk-sharing deals, helping to drive down prices paid by the NHS. Under the new regime, to be phased in by 2014, "value-based pricing" will take the place of NICE review and the old pricing scheme. An NHS board will negotiate prices directly with companies, perhaps allowing drugmakers to set initial prices that would then be subject to review.
Plenty of questions remain--and plenty of time for industry to weigh in with the government. Expect lots of fine-print negotiations over the next couple of years.