Speaking at the NICE annual conference this year, the Secretary of State has given a further indication of how value-based pricing might work when the current Pharmaceutical Price Regulation Scheme ends in January 2012.
Although NICE will continue to examine the cost effectiveness of drugs, it will no longer be making the crucial decision as to whether or not a new drug should be funded. Instead, the Government will set price thresholds to reflect the burden of disease and unmet need, which will be used instead of the £30,000 incremental costeffectiveness ratio (ICER) per quality-adjusted life years (QALY) measure currently used by NICE.
Once a value-based price is agreed between the Government and the drug company, clinical commissioning groups will have a legal responsibility to provide access to therapies approved under the new scheme, just as primary care trusts are currently required to fund a drug subject to a positive technology appraisal. Patients’ rights to access drugs in accordance with the NHS Constitution will, it is therefore said, remain.
The Association of the British Pharmaceutical Industry believes that the prices agreed under the proposed new value-based system should remain secret in order not to deter global pharma companies from doing business in the United Kingdom. The Secretary of State however, has promised that the new system will be open and transparent.
Questions have also been raised about how the fine detail of the system will work in practice, giving rise to concern that drug companies will not be ready when the policy goes live in 2014.