Drugs dilemma as NHS sets priorities
TENS of millions of pounds would be needed to introduce all potential drug developments – and that money is simply not available, Fenland health chiefs were told. The NHS needs to manage the introduction of new drugs robustly to ensure health gains are m
TENS of millions of pounds would be needed to introduce all potential drug developments - and that money is simply not available, Fenland health chiefs were told.
The NHS needs to manage the introduction of new drugs robustly to ensure health gains are maximised "and money is not inappropriately diverted from other treatments or services." East Cambs and Fenland Primary Care Trust heard on Wednesday.
Members heard that in recognition of the risk posed by unplanned high cost drug expenditure "only exceptional clinically urgent requests for funding new high cost drugs are being considered."
Arrangements now under discussion will change the way new drugs are introduced but the emphasis will be on primary care trusts being able to "fully understand how each high cost drug is used."
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The trust was told that earlier this year a list of over 80 drugs was collated, together with an estimate of their clinical and financial impact.
Experts were then asked to prioritise drugs, as relative priorities in Cambridgeshire and Peterborough in 2006/7, being asked to group the drugs as high, medium or lower priority relative to all this year's drug developments.
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Three treatments recommended by the National Institute for Healthcare and Clinical Excellence (NICE) were picked out as being the ones to fund the soonest, said the report to the PCT.
- Anti-TNF drugs such as etanercept or infliximab for rheumatoid arthritis
- Pegylated Interferon plus Ribarvin for moderate/ severe Hepatitis C who meet the criteria set out to help patients benefit from this treatment
- Teriparatide for prevention of osteoporosis in a small number of patients who have not responded to the other treatments available for this condition.
Dr Liz Robin, Director for Public Health for East Cambridgeshire and Fenland PCT, said: "The costs associated with other drugs recommended by NICE and drug costs associated with other changes would create an additional demand in the health system for many millions of pounds. If this money was to be spent on drugs, other services would have to be cut."
Business cases will now have to be made for using new drugs, but, following legal advice, health chiefs have ruled against a blanket ban. Instead, the trust authorised the introduction of a county-wide exceptional items process.
Initial estimates suggested that £13 million would be needed this year if all the highest priority drugs were funded throughout the county, and the full year affect for next year could be £25 million.