UK health authorities ordered to pay for drugs

LONDON, Dec 05 (Reuters Health) - The UK government said on Wednesday that health authorities are to be legally obliged to pay for drugs recommended by a controversial cost effectiveness watchdog.

There has been criticism that even when drugs are recommended by the National Institute for Clinical Excellence (NICE), authorities do not always have the money to pay for them.

To tackle this problem Health Minister Lord Philip Hunt said the government would now issue directions placing the authorities under a legal obligation to provide funding for recommended treatments.

"The government is fulfilling a commitment to introduce a statutory obligation on the NHS (National Health Service) to provide funding for treatments and drugs recommended by NICE," he told the Institute's annual conference in London.

"From the 1st of January 2002, the NHS will have 3 months from the date of publication of each technology assessment to provide funding, so that clinical decisions made by doctors involving NICE-recommended treatments...can be funded," he added.

A spokesman for the Association of the British Pharmaceutical Industry (ABPI) said it was still concerned that the authorities would not have enough money for new drugs recommended by NICE. "There is a need for funds to be specially ring-fenced to pay for the NICE recommendations," he told Reuters Health.

While the Department of Health estimates that more than £250 million will be spent this year on treatments recommended by NICE, the ABPI said this assumed all NICE recommendations were fully funded. "Our estimates fall way short of that," the spokesman said.

According to the Ministry, £76 million will be spent on NICE guidance on heart disease interventions, £30 million on drugs for breast and ovarian cancer, and £10 million on drugs to treat leukaemia and cancers of the pancreas, lung and brain.

Opening the meeting, NICE chairman Professor Sir Michael Rawlins said that when the Institute was set up, he was accused of being a lackey of government charged with cutting spending. "In fact, NICE's advice so far has increased the drug bill by over £250 million per annum."

He accepted that the implementation of NICE guidance had sometimes been slow and patchy. Whereas prescribing of the anti-obesity drug orlistat and the anti-cancer taxanes had risen steeply after they were recommended by NICE, the prescribing of drugs for Alzheimer's had been slower.

Rawlins criticised pharmaceutical industry claims that NICE would find it impossible to assess new products before they had been on the market for 2 or 3 years.

"Of the 11 pharmaceuticals that have been appraised within 2 years of their launch, it has been possible to fully appraise both their clinical and cost effectiveness in all but one case," he said.

NICE chief executive Andrew Dillon said that the Institute had already published 30 technology appraisals and would publish another 22 in 2002-2003. He said that NICE also aims to eventually publish 18 clinical guidelines a year.