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NICE chair: pharma must show how it prices drugs

pharmafile | April 28, 2014 | News story | Research and Development, Sales and Marketing Goldacre, Haslam, NICE, VBP, all trials, pars 

The pharmaceutical industry must be willing to show the public how it prices its drugs – or face losing its trust.

This is according to the chairman of NICE Professor David Haslam, who tells Pharmafile that currently no one outside the boardroom of a pharma firm knows how it evaluates a drug’s worth.

“If we could have greater transparency about pricing, then a lot of problems could be bypassed – it’s not just that drugs are expensive and NICE says no, it’s about the cost-effectiveness of
these medicines. 

“If we could understand why – I mean really ‘why’ – these drugs are so expensive well this might have an impact on the way decisions are made.” During the interview – which follows one year after Haslam took on the role of NICE chairman – he repeatedly reveals the frustration the watchdog endures when it comes to assessing new drugs. 

He says knowing how pharma comes to a decision about cost could change the way NICE views these medicines – and that being more open might allow the watchdog to make a more concise decision on whether a drug passes through its appraisal system.  

This is especially true when it comes to new cancer drugs which he says are ‘extremely expensive’ – but adds that no one has any idea how a company decides why the price should be set so high. Between 2000 and 2014 NICE said ‘yes’ 58% of the time to new oncology products, but the 42% of the time that it does says ‘no’, it is often attacked in the British tabloid press.  

This is another source of frustration for the body, says Haslam: “I’m always slightly puzzled by the criticism from the media which is normally aimed at NICE for saying no rather than at the industry for having high prices…you know it takes two to tango.” 

He adds that it is ‘extremely important’ that the watchdog defends it position when attacked in the media, and wants more engagement with the public so they understand just what they do, and why.

Data transparency

And this transparency agenda should spread to clinical data, Haslam argues. Last year, NICE signed the AllTrials register, something set up by Sense About Science, the BMJ, Dr Ben Goldacre and others that asks pharma to release all of its clinical trial data.

At the beginning of April, a new EU law (the Clinical Trial Regulation) took a step toward realising this desire as it will, from 2016, ensure that data from new drugs should be published. 

Asked whether he was pleased about this latest development, Haslam says: “Absolutely I am – but to be honest, I’ve met a lot of people from the industry over the last year and had a lot of helpful, mainly off-the-record conversations, and I’ve found that most people from the industry absolutely get this [the need for transparency].”

He adds he has spoken to pharma leaders who understand the transparency debate and its importance in terms of both the future of the industry and public trust. For all these reasons, he explains, the issue is ‘incredibly important’. 

“And I must say there are folks in the industry who are tearing their hair out looking at what happens to their reputation around some of these issues – and there is an answer [i.e., to be more transparent]. 

“So for me, we need greater clarity as to why drugs are priced so highly. And I’m not naïve – I do understand that the pharma industry is not a charity.

“Most of the people I’ve met and work with are clearly committed to making a difference to patients and the public – but we just need to find a way that the industry is both viable and transparent, whilst also bringing innovations to the market as quickly as possible.”

Ben Adams

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