UK-US price deal sees increase to NICE threshold on new medicines
The UK has agreed a deal with the US to increase the NICE cost-effectiveness threshold for new medicines in return for a 0% tariff on pharmaceuticals.
Under the deal – which has been estimated will cost the NHS £3bn a year – the UK has also committed to increasing investment in new medicines from around 0.3% of gross domestic product to 0.6% over the next decade.
The Government said the agreement, which will see the NICE threshold rise from £20,000-30,000 per quality adjusted life year (QALY) to £25,000 to £35,000, would secure medicines access for NHS patients and boost confidence in the UK life sciences sector.
But critics called for an impact assessment raising concerns that it would mean less money for other parts of the NHS.
The UK-US Economic Prosperity Deal was agreed after threats from US president Donald Trump that he would raise tariffs on unbranded drug imports.
Pharmaceutical companies had ditched or paused nearly £2bn in planned UK investments so far this year in response to concerns around drug pricing and incentives for innovative medicines, the Guardian reported in September.
The changes to the NICE threshold – the first in 20 years – will mean the approval of three to five new drugs a year in addition to the 70 that already make it through the process.
It will equate to a 25% increase in new medicine pricing.
Updates are also being made to values placed by the public on health related quality of life and how good or bad they believe different health states to be, which could also impact how cost-effectiveness decisions are made, NICE said.
Health minister Zubir Ahmed said: ’This deal is fundamentally about putting patients first – patients and families facing serious illness, this represents new hope and the possibility of treatments that could transform and even save lives.
‘This package of changes will bring the best of pharma to the UK for the benefit of our patients, our NHS and our economy.’
The Association of the British Pharmaceutical Industry welcomed the plans as an ‘important step’ towards ensuring patients can access innovative medicines faster.
Professor Andrew Morris, president of the Academy of Medical Sciences, also welcomed the Government’s intention to increase investment in medicines.
‘A thriving UK life sciences sector is vital for patients – delivering both the drugs that keep us well and the research that helps us live healthier lives,’ he added.
But several health economists pointed out the NICE threshold was already too high and the changes would likely have a negative impact on other healthcare spending.
Professor Karl Claxton, professor of health economics at the University of York, had already co-written an open letter to the Government to raise concerns before the deal was agreed.
In response to the announcement, he said: ‘Government conceding to the pressure to increase how much the NHS pays for new drugs will have a catastrophic impact on NHS patients, the social care sector and local economic growth, which will not be compensated by any affordable new drugs or inward investment in the UK,’ he said.
‘The value of the harm likely to be done, whether or not the Treasury or the NHS ultimately picks up the bill, will far exceed the value of any impact on the UK pharmaceutical sector due to tariffs that might be imposed.’
He added: ‘We urgently need to see an impact assessment, which takes account of the full weight of robust research evidence with a comprehensive valuation of all the impacts.’
Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London, said faster access to innovative treatments for conditions such as cancer would be welcomed by patients and clinicians, and increased investment in medicines may help the UK attract more clinical research and early launches.
‘However, the impact of these proposals will depend heavily on implementation. Raising NICE’s cost-effectiveness thresholds is likely to increase overall NHS spending on medicines.
‘Without corresponding investment in areas such as workforce, diagnostics and primary care, there is a real risk that higher drug spending could divert resources from other essential parts of the NHS.’
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