New NICE evals could green-light more drugs, but only at 'the very best price'

NICE CEO Sir Andrew Dillon

The U.K.'s cost watchdog is changing up the way it evaluates drugs. The National Institute for Health and Care Excellence (NICE) will be zooming out to look at the bigger picture when assessing therapies, which could result in more positive recommendations--something drugmakers have been dreaming of for years.

But there's a catch: As NICE Chief Executive Sir Andrew Dillon told Reuters, those recommendations will only come if drugmakers keep their prices in check.

"It has the potential for increasing the number of positive appraisals that NICE produces, but that is only going to happen if companies offer the very best price to the NHS (National Health Service)," Dillon said.

As the news service reports, NICE, which determines which new therapies make it through the country's cost-effectiveness gate for use in Britain's state-run health service, will examine the "wider societal impact" of new meds going forward. This model could include factoring in whether a drug will help a patient return to work, in turn paying more taxes, which benefits society.

It's a move that could quell some of pharma's longtime griping. As it stands, NICE's evaluation centers on the additional quality-adjusted life years (QALYs) that new drugs offer, forcing their makers to offer so-called "patient access schemes"--discounts that bring the price per QALY below a ceiling that generally falls between £20,000 and £30,000 ($33,000-$50,000)--in order to win reimbursement.

Several drugmakers have criticized the current system, which has left many a hot new drug out in the cold; in October, Eisai went as far as to threaten to stop investing in Britain unless NICE widened drug-approval criteria the Japanese pharma claimed were too limited.

But not everyone is enthused about the new scheme. As Reuters notes, the focus on societal impact is spurring fears of discrimination against patients perceived as less able to contribute, including the elderly.

"The ultimate aim should be to increase overall access to innovative, effective medicines for conditions that impose a substantial burden on patients and society," Paul Catchpole, the director of value and access at the Association of the British Pharmaceutical Industry (ABPI), said in a statement. "There is, however, a huge amount of work to be done to make this happen."

- get more from Reuters
read the ABPI statement

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