Government seeks to salvage pharma pricing reforms
pharmafile | July 19, 2011 | News story | Sales and Marketing | NICE, value-based pricing
The government is pushing ahead with plans to introduce value-based pricing in 2014, despite acknowledging the new system still requires much development.
The lack of detail on its plans to scrap the current PPRS system had led many to conclude they had stalled, weighed down by greater concerns over the Health and Social Care Bill.
Now, four months after the pricing reform consultation ended, the government has finally published its response, part of which proposes a central but as-yet undefined role for NICE.
It also notes that a number of other vital points have yet to be thrashed out, including how the value of new medicines will be measured and assessed, but says value-based pricing (VBP) will still be introduced in less than three years.
Once in place the government also wants VBP to give pharma “clear signals about priority areas” so industry research focuses on “areas that can make the most important improvements in health outcomes”.
Health secretary Andrew Lansley said: “We are modernising the NHS so we can give patients better access to the medicines they need. To do this we need to change the way drugs are priced and ensure value for money for the NHS.
“It is vital that doctors are able to prescribe medicines that they think will benefit their patients. They must be able to focus on what matters most – achieving the best health outcomes for their patient, not debating the price of a drug. Value-based pricing will ensure this happens.”
He added that the government would work with patients, clinicians, the NHS and pharma to develop a VBP system that ensures NHS patients have “consistently good access” to the medicines that they need.
The ABPI said it supported the ambition to improve access to effective medicines, but it had serIous concerns the plans could hamper other government initiatives to nurture life sciences in the country.
“We have still to see a clear vision of the system that will succeed the current PPRS, which has traditionally met patient needs and supported an important research and development based UK industry,” the industry association said in a statement.
Meanwhile, NHS managers expressed concern over key elements of the plans and questioned how realistic a timetable that only allowed two and a half years to implement VBP could be.
NHS Confederation chief executive Mike Farrar said: “We still have reservations about the impact the proposals will have on driving innovation. We remain concerned about the difficulty in defining what innovation is and whether commissioners should pay a premium for innovation.
“It is also uncertain whether it will be feasible to introduce this new system by 2014, given the government has acknowledged that extensive testing of the system will be necessary.
Value-based pricing and NICE
Where NICE sits alongside a value-based pricing system remains unclear, following the government’s decision to allow NICE to retain its authority to direct the NHS on new drugs.
Buried within the 43-page consultation document is the acknowledgement that the government itself doesn’t have a definite answer to this question.
“We have not yet determined the roles of individual bodies within the value-based pricing arrangements, but, we envisage NICE will have a central role in the VBP system including undertaking the planned pharmacoeconomic evaluation, in which it is a world leader,” it said.
The pharmaceutical industry too faces much uncertainty from the reforms, some of which is likely to be resolved next year.
The government said it hopes it will be possible to replace the voluntary PPRS with a similarly “negotiated agreement” on value-based pricing, and expects talks with pharma to begin “sometime in 2012”.
Dominic Tyer
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