Drugs firms taking NHS to court in an unprecedented bid to block ‘wrong and unnecessary’ rationing
The Association of the British Pharmaceutical Industry wants to overturn the rules that have been in effect since April
DRUGS firms are taking the NHS to court in an unprecedented bid to block "wrong and unnecessary" rationing.
The Association of the British Pharmaceutical Industry wants to overturn rules that allow officials to restrict access to costly treatments.
It has applied for a judicial review of a decision by NHS England and the National Institute for Health and Clinical Excellence (Nice).
Since April, drugs are no longer automatically funded if they are set to cost the NHS more than £20m a year.
The money-saving measure applies even if Nice rules the drugs offer good value.
Nice estimates the policies will affect one in five of the new medicines produced by the pharma industry each year.
One consultancy found 24 new drugs would have seen access curbed if the rule had been introduced from September 2012.
These include treatments for cancer, hepatitis and cystic fibrosis.
These include treatments for cancer, hepatitis and cystic fibrosis.
Anita Charlesworth, from the Health Foundation think tank, said the move – yet to be triggered – amounted to “overt rationing on affordability grounds”.
Richard Torbett, executive director at the ABPI, said the ABPI says it is acting in patients’ best interests.
He added: “This is not a debate about whether the price is too high.
“These are medicines for which Nice has given the stamp of approval of cost effectiveness.
“It fundamentally crosses a line to not grant mandatory funding for Nice-approved medicines. This has been a part of the Nice regulations for many years and indeed is a right enshrined in the NHS constitution.
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“We think the legal case is so strong that if we hadn’t taken this action given the strength of feeling somebody else would have looked to do so, possibly an individual patient.
“I believe we’re doing the right thing in terms of getting patients access.”
Rachel Power, chief executive of the Patients Association, said: “NHS England’s decision not to fund new medicines recommended by Nice was an astonishing admission that our NHS can no longer afford to keep up with scientific breakthroughs.
“This is a direct result of the government’s decision to under-fund the NHS. Patients throughout England will hope that this legal action forces a re-think.”
Baroness Morgan of Drefelin, chief executive of the charity Breast Cancer Now, said she hoped the legal case would “provide clarity on the issue of timely access to drugs in England”.
She said the £20m threshold would be a “major hurdle” for cancer drugs, adding: “We remain extremely concerned that the budget impact test could see NHS patients experience delays in accessing vital and cost-effective drugs.
“Any further delays could sadly see patients lose their lives as they wait.”
Simon Stevens, head of NHS England, has said there is no reason why new drugs should “crowd out” spending on extra nurses, mental health staff or other effective ways to treat people.
Speaking earlier this year, Sir Andrew Dillon, chief executive of Nice, said the proposals were designed to “address the challenge of providing faster access to innovative, cost-effective treatments alongside the need to safeguard the future financial sustainability of the NHS”.
A High Court hearing is expected in the next few weeks. The NHS and Nice declined to comment.