Determining the value of drugs – the evolving British experience

I don’t like politicising this blog, but the issue of prescribing expensive drugs in the NHS is something we need to do if we want to change the natural history of MS. I urge you all to read the policy article in the latest issue of the New England Journal of Medicine on the proposed changes to prescribing in the NHS.

Briefly, the government is proposing a shift to value-based pricing; i.e. there would be a basic price threshold, that will allow the Dept of Health to negotiate prices for new drugs with manufacturers. Final prescribing decisions would be left to individual GPs who will be given a defined budget and need not follow existing decision-making processes, in particular NICE or specialist guidelines, such as the ABN guidelines in the case of MS. The new approach would require GPs to consider; (1) the burden of illness related to the condition to be treated, defined in terms of the unmet need for treatment or the severity of illness; (2) the extent of therapeutic innovation involved; and (3) the “wider societal benefits.”

“Are GPs in a position to make these judgments? Will this lead to post code prescribing? Will the changes lead to greater cost savings or at best reduce the rate of rise in drug costs? Will PwMS have access to the newer more effective emerging therapies? These are all important questions; PLEASE HAVE YOUR SAY IN OUR POLL!

Faden & Chalkidou. N Engl J Med. 2011 Apr 7;364(14):1289-91.

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