Unfunded promises as the UK health debate takes centre stage

Abstract

On May 6, 2010, the UK population will vote to decide their government for the next 5 years, and health policy is likely to be a major factor in the outcome. Politicians know health is the “ace up the sleeve” if used cleverly and, with just a few days to go until the election, the card tricks have started. The Conservative leader, David Cameron, has pledged to reverse the 1% increase in national insurance (NI) contributions proposed by the Labour party, and to use the employer NI contribution saved within the National Health Service (NHS), estimated at £200 million, to fund drugs licensed since 2005 for patients with cancer, if recommended by their oncologist—even where the National Institute for Health and Clinical Excellence (NICE) has ruled against their use on the grounds of cost-effectiveness. This pledge is a laudable one—provided treatments are the most clinically effective available—and will win votes, but raises a number of questions, not least the need for NICE if it can be circumvented so easily. 10 years of NICE: still growing and still controversialThe National Institute for Health and Clinical Excellence (NICE) will have existed for 10 years on April 1, 2009. Over the past decade, the institute's methodological approach to the development of guidance and assessment of the value of health-care interventions has received international interest and acclaim. Furthermore, individual decisions, in particular those made on new cancer drugs, have generated enormous controversy. An early example was the appraisal of irinotecan and oxaliplatin for colorectal cancer in 2002. Full-Text PDF Patient access schemes for high-cost cancer medicinesInnovative new anticancer medicines are often associated with a premium price with little variation in global prices. For the UK, this can mean new cancer medicines are not adopted, because they are judged to be too expensive and not cost effective by the National Institute for Clinical Excellence (NICE). In response, pharmaceutical companies have developed patient access schemes (PAS), or risk-share schemes, that allow drugs companies to offer discounts or rebates to reduce the cost of a drug to the UK National Health Service (NHS). Full-Text PDF