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Abstract
The recent growth in the availability of “high cost medicine” has challenged the UK government’s commitment to providing a comprehensive service, free at the point of delivery, when doing so has a substantial impact upon public expenditure. Overall, NHS spending on medicines in 2015–16 was £15.8 billion. Hospital prescribing was 54.2% (£7.6 billion) of this total, with the rest (£9.0 billion) being spent in primary care. In recent years, there has been the rapid growth in spending on drugs by hospitals, which increased from £4.2 billion in 2010–11 to £7.6 billion in 2015–16, a rise of 81.8%. This growth was caused by the introduction of new and innovative medicines, as well as the greater use of specialist drugs. Positive technology appraisals by The National Institute for Health and Care Excellence (NICE) have also placed pressure on the nation’s drugs bill. The purpose of this chapter is to provide an overview of NHS policy to control public expenditure on high cost drugs in England. To analyse current policy, the following tasks are performed. First, background to the current policies for controlling high cost drugs is provided. Second, arrangements and policies for controlling high cost drugs are analysed. Third, the way ahead is discussed. The chapter closes with conclusions.
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