Drugs taking too long to be prescribed after NICE approval, pharma firms warn

NHS managers and clinicians slow to begin process of ensuring newly approved drugs and medical devices are prescribed to patients, costing the NHS more in the long run, pharma companies allege.

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Speaking at the House of Lords science and technology committee hearing into the government’s life sciences industrial strategy, pharma companies said their biggest problem was getting drugs and medical devices adopted into NHS practice after they had already been approved by the National Institute for Clinical and Healthcare Excellence (NICE)

Medicines approved for use in the NHS are taking too long to be prescribed to patients, major pharmaceutical firms have told a House of Lords committee.

Speaking at the House of Lords science and technology committee hearing into the government’s life sciences industrial strategy, Menelas Pangalos, executive vice-president of the Innovative Medicines and Early Development Biotech Unit at Astra Zeneca, said the UK was the most productive country in the world in scientific terms, but that this was not being translated into a commercial return.

The life sciences industrial strategy aims to ensure the long-term success of the UK’s life sciences industry, and it includes a chapter on improving collaboration between the industry and the NHS.

Pangalos told the committee that one of the biggest problems for pharmaceutical firms operating in the UK was getting drugs and medical devices adopted into practice in this country after they had been approved by the National Institute for Clinical and Healthcare Excellence (NICE).

“We need to find a way of working out how, when a drug is approved by NICE, it is used the next day,” he said.

“For a high-income country, we are one of the worst in the world at adopting approved drugs.”

Pangalos accepted that NHS budgets were tight, but warned that short-term decision-making was costing the NHS money in the long run.

“We need to create the room to see how we can save money over the next three years [by prescribing new drugs], as much as we need to save money over the next quarter,” he said.

Mark Campbell, senior manager of Randox Laboratories, which develops in vitro diagnostics, told the committee that his firm had experienced similar problems.

“Ninety-five per cent of our products are exported, but it is difficult when you are selling abroad and you stumble over the question of how your products are adopted in the UK,” he said.

Bryn Sage, chief executive of Inhealthcare, which makes digital home-monitoring products, told the committee that one of the problems was adoption decisions being made by such a wide range of people within the NHS.

“If we can get down to 44 or so accountable care organisations or STPs [sustainability and transformation partnerships] they may be much like the old strategic health authorities, but there should be someone in charge of the local health budget and someone in charge of the social care budget and it would mean we could sell [collectively] to 50 people rather than 500 people,” he said.

Andrew Dillon, NICE chief executive, told the committee he accepted that there could be delays in adoption of drugs and devices after they had received NICE approval.

He said NICE had already committed to providing guidance on cancer drugs within 90 days of their approval, and NHS England had agreed to fund all cancer drugs from the first day of approval.

NICE was consulting on extending its 90-day commitment to all medicines, he said.

Dillon also told the committee that NHS trusts had a statutory duty to fund medicines approved by NICE, although there was no statutory duty to fund approved medical devices or diagnostic agents.

This statutory duty did send a “powerful signal” to clinicians, but Dillon warned that it was no guarantee of implementation across the NHS.

“Then you need to rely on tens of thousands of decision-makers being aware of the guidance and then making those clinical decisions,” he said.

Citation: The Salvadore DOI: 10.1211/PJ.2017.20203751

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