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January 16, 2013 12:00 am
The government’s failure to provide details of a new system of medicine pricing trailed two years ago and due to be introduced in January 2014 is creating unacceptable uncertainty for industry, doctors and patients, MPs warned on Wednesday.
The Commons health committee called on the Department of Health to make public by March plans for “value-based pricing” announced by Andrew Lansley, then health secretary, in December 2010.
It called the new system, which aims to reflect more precisely the value of new medicines to the National Health Service, “nebulous” and said it was unclear what “substantive change” was proposed.
“We do not regard it as acceptable that the arrangements for value-based pricing have still not been settled and that those who will have to work with those arrangements are still unclear about what value-based pricing will mean in practice,” it said.
The criticism came in a report from the parliamentary committee on the National Institute for Health and Clinical Excellence, the government’s medicines advisory body. It also called for the agency to have greater access to information from drug companies.
It comes at a time of growing pressure from some doctors, drug companies and officials to quietly drop the new approach.
The Department of Health has indicated that value-based pricing will only apply to new medicines from January 2014. The vast majority will continue to be priced using the existing “pharmaceutical price regulation scheme”.
While the PPRS nominally allows manufacturers to set prices, in reality a growing number of medicines have already been offered at discounts or with rebates after the price was judged by Nice to be too high to offer value for money.
Stephen Dorrell, the committee chairman, said: “There is a lack of clarity around the whole issue which has persisted for too long. Decisions need to be taken, and the details of the scheme made public.”
The MPs said it was neither “legal nor ethical” that Nice did not always have full access to the results of clinical trials of drugs that were submitted for assessment by the medicines regulator. They called for all such data to be made public.
While largely supportive of Nice, the committee stressed that the institute should remain an advisory body and not be able to instruct clinicians on the best treatments.
It said decisions should remain open to the judgments of doctors and patients, but clinicians and commissioners departing from guidelines should report and explain the divergence.
It also welcomed Nice’s expanded role in assessing social care quality standards and clinical guidelines.
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