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Dozens of MPs have expressed opposition to a health secretary's decision to gain authority over NHS drug pricing. The move involves overriding an institute's judgments on cost-effectiveness amid concerns about legality and potential benefits to pharmaceutical companies. Critics include members from various political parties and a former health secretary.
Mike Burdett from CROMER, UK / Wikimedia (CC BY-SA 2.0)Dozens of MPs are opposing a health secretary's decision to grant himself power to dictate what the NHS pays for drugs, amid concerns that the move may be illegal. Thirty-one MPs have signed a House of Commons motion expressing disapproval of the health secretary being given the power to override the National Institute for Health and Care Excellence's (Nice) judgment on how much the NHS should spend on individual medicines.
They expressed fear that the change undermines the role Nice has played since 1999 as the arbiter of which medicines provide value for money for the NHS in England and Wales.
Background on the Policy Change Nice is viewed internationally as a model for protecting against excessive drug prices charged by companies. MPs from various parties, including Labour, Green, Liberal Democrat, Independent, Scottish Nationalist, and Plaid Cymru, have backed a motion tabled by a Labour MP to show disagreement with the statutory instrument implementing the policy.
A statutory instrument recently gave the health secretary the power to direct Nice on the applicable cost-effectiveness threshold for health technologies under appraisal, as part of a government drug-pricing deal with the U.S. administration. A Labour MP stated that one purpose of establishing Nice was to insulate the NHS from pharmaceutical industry lobbying, and that the changes undermine Nice's independence, potentially giving U.S. pharmaceutical companies influence over drug policies.
A Liberal Democrat health spokesperson said the health secretary received this power because the prime minister had conceded to pressure from the U.S. administration. Ministers have defended the deal as a way to help British drug exports to the U.S. avoid tariffs and provide patients access to potentially life-extending drugs that might otherwise be unavailable.
The MPs' concerns have been joined by a former Conservative health secretary, now a peer, who tabled a motion of regret in the House of Lords. The motion warns that the regulations risk undermining Nice's independence and appear incompatible with the Health and Social Care Act 2012, which states that directions by the secretary of state must not relate to the substance of Nice's recommendations.
The overall UK-U.S. deal has raised alarm among health experts. A thinktank warned that higher NHS spending on drugs will force difficult cuts to other services that improve patients' health more cheaply. An economist stated in a blog that given funding pressures from higher demand and demographic changes, the NHS cannot afford to sacrifice resources for a higher drugs bill in the short term.
" — Editor-in-chief of the British Medical Journal (The Guardian) These remarks echo concerns raised last year by Nice's then chief executive, who noted that limited taxpayer funds mean spending more on medicines foregoes other services, such as hip replacements or nursing staff.
The Department of Health and Social Care stated that Nice's independence is protected and that the changes aim to bring innovative medicines to the NHS, improving access to life-changing treatments for thousands of patients. A spokesperson added that this includes recent approval of a brain cancer drug for patients as young as 12.
A pharmaceutical industry association spokesperson said the change does not give any minister power to tell Nice what decisions to make but clarifies that the government sets the parameters within which Nice operates.
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