NICE gains expanded role alongside value-based pricing
pharmafile | June 21, 2011 | News story | Sales and Marketing | NHS reforms, NICE, value-based pricing
NICE will be given a wider remit to oversee social care and its guidance used alongside value-based pricing as part of new changes to the Health and Social Care Bill.
The government had already reversed its planned downgrading of the Institute in the wake of the ‘pause’ to NHS reforms, and has now begun outlining how NICE guidance will fit alongside changes to the way medicines are priced.
The proposed value-based pricing (VBP) system is still set to replace the current PPRS from January 2014, after which manufacturers will directly negotiate prices with the government based on the system’s new definitions of value.
When this price is decided, NICE will be asked to assess the cost effectiveness of a drug, given its newly-agreed price, and make recommendations on its use to the NHS.
The government, forced to make another U-turn on a key reform pledge, said it was now ‘committed’ to using NICE’s recommendations and that this will be translated into new regulations under the Bill.
Its previous plans would have stripped NICE of its powers to recommend which drugs the NHS should pay for, but this was clearly in breach of the NHS Constitution.
The Constitution makes the Institute’s role quite clear, saying “[patients] have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if [a] doctor says they are clinically appropriate”, meaning NICE’s current role had to remain.
NICE – the National Institute of Clinical Excellence – will also be renamed the National Institute for Health and Care Excellence, to reflect the expansion of its remit to cover social care.
In addition, NICE will also have close links to the newly established NHS Commissioning Board, a central body set up to govern clinical commissioning groups that will be taking on the health service’s budget.
But the government said that “to guarantee that [NICE] advice remains independent, the Bill prevents the Secretary of State or the NHS Commissioning Board from interfering” with the Institute’s advice and guidance.
Ben Adams
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