Access to pharmaceutical drugs could cause patient care revolution

Lord Darzi’s plans to give patients better access to the latest available pharmaceutical drugs could cause a revolution in patient care.

By Norma Beavers

Lord Darzi’s plans to give patients better access to the latest available pharmaceutical drugs could cause a revolution in patient care, said Dr Richard Barker, Director General of the Association of the British Pharmaceutical Industry (ABPI). “Collectively, the measures announced by Lord Darzi represent the basis for a huge leap forward in driving the use of best available treatment, including the uptake of NICE guidance, across the NHS,” he said.

Chris Brinsmead, President of the ABPI, said: “We welcome a series of measures that offer the opportunity to effect a seismic change in patients’ rights to access the best and most modern medicines based on clinical need. We look forward to working in partnership with Government and other stakeholders to ensure that this opportunity is realised.”

The mission facing the NHS and its partner organizations is “to deliver on the promise, so that people across the UK have full and fair access to innovative, life-extending medicines, demonstrated to be clinically-effective and cost-effective,” Barker said.

Darzi’s plans “are good news for patients, who can now look forward to receiving the same standard of care wherever they live, rather than on the basis of a postcode lottery,” Barker added.

Prof. John Appleby, Chief Economist at The King’s Fund, said while Lord Darzi’s plans should go some way towards reducing the postcode lottery in access to drugs, “the main area of dispute occurs when some PCTs are reluctant to fund drugs that have a licence but which are yet to be evaluated by NICE.”  Dealing with this source of variation is more difficult and may well require central guidance to ensure consistency across the NHS as well as the proposal that PCTs need to explain their local judgements regarding funding of drugs yet to be evaluated by NICE, Appleby said.

An even more important source of variation in access to care arises from differences in the clinical decisions of doctors about who to treat, when and how, he said. “Rates of the most common operation in the NHS – cataracts – can vary more than four-fold across England, for example. The Department of Health and the NHS need to put much more effort into understanding why such variations exist and what needs to be done to ensure more equitable access, ” said Appleby.

Darzi has put forward plans to speed up the NICE approval process. Appleby noted: “NICE grapples with the difficult decisions about what the NHS should fund and is recognized worldwide as a real success for its cost effectiveness evaluations. Although its work is both rigorous and transparent there have been concerns that its decisions take too long. Moves to speed it up are good news for patients, however, NICE needs to be careful not to sacrifice rigor for speed.” 

Dr Barker forecasts that “Britain’s innovative pharmaceutical industry will also gain from Darzi’s blueprint for the NHS, by serving a more innovative customer, one that will also be a more attractive location for future clinical trials – a further benefit for UK patients.”