Report: U.K. weighs drug rationing as National Health Service (NHS) England’s budget tightens

Beginning in April, cancer patients and others could have to line up for medicines that cost NHS England more than £20 million per year, The Times reported.  That is even after those meds have been deemed cost-effective by the National Institute for Health and Care Excellence (NICE).  The move comes at a troublesome time at NHS, as its Chief Executive, Simon Stevens, said publicly this month that Prime Minister Theresa May was “stretching the truth” about the agency’s budget.  He said NHS received “less than we asked for” from the British government.

Currently, patients in England have legal access to drugs that have been approved by the cost watchdogs at NICE; however, that could change, according to the newspaper.

The country’s Pharmaceutical Association, ABPI, pointed out some medicines that could see rationing.  On the list is Johnson & Johnson’s prostate cancer med Zytiga, used by about 2,000 patients.  Merck’s cholesterol med Zetia could be another; it is used by 159,000 patients.

ABPI Chief Executive Mike Thompson described a £20 million budget cap for drugs as “both heavy-handed and unrealistic,” adding in a statement that it “will mean more patients face delays in accessing appropriate NHS care.”  Additionally, Thompson said, “Better long term planning by the health service would ensure that major breakthroughs are managed into the NHS in an appropriate and affordable way and with less disruption”.

Under the cost-cutting plan, “people could die while waiting for treatment,” Dr. Hilary Jones, a General Practitioner and medical broadcaster, said on Britain’s talkRADIO.  And drug makers said they will hold off with new launches in the country if the plan goes through, according to The Times.

Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said the group is “hugely concerned” that the plan “would be a massive setback for access to new cancer drugs in England.”  “Ultimately, with one in five new drugs set to be delayed by the proposed cap, we fear this country really could be left behind in access to the newest and best treatments,” she said in a statement.

NHS, while declining to comment on rationing, has released some details on its efforts to address budgetary problems.

The Agency determined that, based on NICE appraisals between April 2015 and July 2016, 81% of medicines would fall under the £20 million a year “budget impact threshold” for a total spend of £125 million.  The 19% of drugs above the threshold had a budget impact of nearly £400 million.

“This is about introducing cost effective, but expensive treatments onto the NHS in a way that does not compromise its ability to fund other areas of work,” according to NHS details on the efforts.

For drugs above the threshold, NHS said it will review its options, including negotiations with Pharma companies.  However, £20 million is “not necessarily” the most NHS would spend in one year on a new drug, according to details on the plan.  NHS also might ask NICE to amend a 90-day requirement forcing its organizations to pay for recommended therapies.

Editor’s note:  This story was updated with comments from ABPI chief executive Mike Thompson and Breast Cancer Now chief executive Baroness Delyth Morgan.

BLOG NOTE:  The National Health Service (NHS) is the publicly funded national healthcare system in the United Kingdom.  The organization, funded primarily by taxation, provides free or low-cost healthcare to all legal residents of the U.K. Medications are subsidized as well and prescriptions may be free when situations warrant.

REFERENCE:  Fierce Pharma; 19 JAN 2017; Eric Sagonowsky

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