Table of Contents
- CHAPTER 1 EXECUTIVE SUMMARY
- Scope of the report
- Key findings
- CHAPTER 2 BRIEF OVERVIEW OF UK PRICING & REIMBURSEMENT ENVIRONMENT
- Introduction
- The UK uses a range of P&R tools to regulate drug costs and usage
- Potential future changes to the UK P&R system
- Additional cost containment tools are used in conjunction with P&R
tools
- The PPRS is the primary mechanism used to control drug prices in the UK
- Introduction to the PPRS
- Has the PPRS worked?
- The future of the PPRS system: is it going to be replaced with
value-based pricing?
- A number of bodies and policies impact drug prescription and spending in
the UK
- CHAPTER 3 NICE: ITS ROLE, EFFECTIVENESS AND ISSUES
- NICE plays a key role in UK drug reimbursement
- Introduction: what does NICE do?
- NICE and pharmacoeconomics
- How does NICE determine which drugs to assess?
- A number of issues have been raised with NICE' s appraisal process
prompting several reviews
- Time delays caused by NICE are a significant issue
- But are time delays a significant issue for drug developers?
- The solution: there are two key ways to accelerate drug access through
improving NICE
- Earlier guidance can be provided by starting standard appraisals
earlier
- Using STAs should also help to accelerate drug approvals in the
future, although they have had limited success so far
- NICE assessments have created significant controversy
- NICE has faced significant controversy over its assessment of oncology
and Alzheimer' s disease drugs
- NICE' s controversial decisions over oncology drugs
- NICE' s guidance over Alzheimer' s disease drugs has also been highly
contentious
- NICE needs to become more responsive
- NICE has historically faced significant criticism that it is not
responsive enough
- NICE is becoming increasingly responsive to stakeholder activism and
consultations
- NICE changes its mind following consultation
- Patient, physician and charity activism can help to change NICE
responses
- NICE needs to use assessment factors other than QALYs to make decisions
- NICE has an over-reliance on QALYs to the detriment of other
assessment factors
- NICE becomes more flexible by offering risk-sharing agreements: the
Velcade story
- Future changes in the influence of NICE
- Going forward, there is set to be a greater interaction between NICE
and other HTA bodies
- Potential future changes to NICE function and influence
- Is there a possible role for NICE in drug pricing?
- NICE guidance set to continue to guide drug provision decisions, yet
the government shows greater flexibility in providing access to cheaper
drugs
- CHAPTER 4 BIBLIOGRAPHY
- Publications and online articles
- Datamonitor resources
- APPENDICES
- Appendix A: Glossary of terms
- List of Figures
- Figure 1: A range of P&R tools are in use across 5EU markets, with
many of these being used in the UK
- Figure 2: Regional differences in NICE influence
- Figure 3: NICE published technology appraisal guidance for drugs has
focused heavily on oncology drugs to date
- Figure 4: NICE topic selection process
- Figure 5: Datamonitor has identified four key issues that NICE will
need to address going forward
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