Government must free NICE to unlock access to medicines for severe conditions

The board of NICE has today decided not to change how it values medicines for those with severe health conditions, meaning some patients will continue to miss out on treatments that would have been approved under a previous system.

At the same meeting, the NICE board committed to conducting further research into how the public wants medicines for severe conditions to be valued, but set a timeline of over two years before this work would report back.

Commenting on the decision, Paul Catchpole, Director of Value and Access Policy for the ABPI, said:

“We are disappointed but not surprised by this decision. NICE’s hands have been tied by having previously been instructed to ensure that any change to its methods did not result in higher costs overall.

“We argued strongly when this constraint was introduced that it would be seen to be unfair on those patients who would inevitably miss out - and miss out unnecessarily - due to other strong spending controls on the medicines budget agreed with the industry.*

“We welcome NICE’s commitment to reassess the public's willingness to fund medicines for severe conditions, but we also urge NICE to be more ambitious about how quickly they complete this work. Patients may see the proposed two-year timeline as kicking the issue into the long grass.

“Ultimately, government may need to step in and release NICE from its current constraint, so that people with severe illnesses can receive the innovative treatments they need while the NHS remains secure in the knowledge that this will not increase costs for above an agreed level.”

* Under the 2024 Voluntary Scheme for Branded Medicines Pricing and Access (VPAG) between government and industry, the NHS branded medicine budget is fully controlled. If the NHS spends more on branded medicines above an agreed ‘cap’, the industry returns the excess in the form of a direct rebate on sales. The agreement is indented to ensure that the NHS can focus freely on how best to treat patients and avoid restricting innovative treatments because of their cost.

To find out more about the severity modifier and how it works, read: ‘Understanding medicines access: a look at the severity modifier and its impact.’