Sunday, 22 August 2010

NICE, drugs and the (sort of) National Health Service

Will the spate of reforms in health care see a reduced role for the right-wing hate figure that is the National Institute of Clinical Excellence (NICE)? 

The British Medical Journal are certainly hinting that that may well be the case, and pre-election comments by Andrew Lansley suggest that its key role in assessing the 'value' of medical treatments may be on the way out. This will no doubt delight many in the pharmaceutical industry.

NICE, the original target of many of the hysterical 'death panel' stories circulating in the US, plays an important role in ensuring that drugs purchased by hospital trusts are medically effective - in essence helping to prevent drugs companies from profiting from the sale of treatments that have little in the way of proven efficacy.

Currently the system allows for purchasing decisions on licenced drugs to be made initially at a local level. However, NICE makes nationally-binding recommendations where there is uncertainty in the apparent value of a medical treatment.

If health service commissioning is fragmented, and NICE loses its key role in influencing the purchasing decisions of NHS Trusts, then there is a huge danger that the balance of power will tilt in the direction of private drugs companies, driving up costs for UK patients. 


Equally importantly though, is what the current government will do when the current Pharmaceutical Price Regulation Scheme (the agreement between the Department of Health and the major pharmaceutical companies over prices and other related regulations of licenced drugs) expires in 2014. It looks likely that the system will end - the question will be what takes its place?

Now, there is no doubt that the huge bargaining power of the NHS has not been best used in the past. If a new pricing system can redress this deficiency, then all the better.

The question is, will a Coalition government that has planted its flag firmly in deregulation territory be willing to fight hard to get a good deal for the NHS (or whatever it is that British health care system will be in 2015)?

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