Recent reports of the death of NICE are greatly exaggerated. Its power to decide which medicines the NHS can use may well be curbed once value-based pricing is introduced in 2014, but if you’re jumping up and down at the watchdog’s loss of HTA responsibilities it’s perhaps best to curb your enthusiasm. Ignore the media rhetoric: NICE, unlike many in today’s NHS, is not facing the prospect of redundancy. In fact, its remit is to be extended, and the industry may find that the new system has more teeth than the old.
Back in the summer, the widespread furore over the abolition of PCTs and SHAs and introduction of GP-led commissioning took centre stage as the UK absorbed the coalition government’s blueprint for the NHS. But the repositioning of NICE, itself evident within White Paper, somehow avoided the spotlight. But it is now getting the full glare of media attention. As Lord Howe reminded an ABPI audience earlier this month, the White Paper made it clear that NICE’s role would be extended. Its work developing national quality standards has already begun. These standards will be central to the work of the NHS Commissioning Board and GP consortia, and will strengthen NICE’s ability to drive the clinical agenda for the NHS. It will still play ‘an essential advisory role’ in appraising drugs, even if its authority to make final decisions has been passed elsewhere. And, tellingly, NICE is to be re-established in primary legislation, with its work extending into social care. These are not the signs of an organisation whose powers are on the wane.
As talk of pricing gathers pace, the issue of what constitutes value has come back to the fore. The Government has confirmed it will support the existing PPRS agreement in full, but beyond it, the future is unclear. What does appear certain, however, is that the industry faces some tough discussions at it seeks to negotiate a fair price for its medical innovations. Identifying and demonstrating value has never been more important.
The value of the pharmaceutical industry remains unquestionable. At a time of heightened fiscal turbulence, the Government has said it recognises the important role life sciences can play in driving growth in the UK economy and claims its policies are designed to support innovation, increase patient access to medicines and, in the process, improve the health and wealth of the nation. Its decision to protect the NHS budget and to give ‘real terms’ increases in every year of the Parliament have been welcomed by many. But have also not escaped criticism from those who claim the figures represent a cut masquerading as an increase.
But the ‘real term’ impact of value-based pricing and the refocusing of NICE’s priorities will take some time to emerge.
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