Deputy Peter Roffey, a former Health minister, used question time to ask why Guernsey patients were ‘denied funding for cancer drugs’ that UK residents have access to.
‘Given that the National Institute for Clinical Excellence (sic)has far more expertise and experience in assessing the efficacy and cost effectiveness of drugs, and drug treatment regimes, than anybody in Guernsey, why are Guernsey patients with serious or life threatening conditions being denied access to drugs which are Nice-approved and available on the NHS?’ he asked HSC president Heidi Soulsby.
She stood by her committee’s policies. ‘Nice guidance is treated as advisory and provides a useful review of evidence and cost-effectiveness,’ she said.
‘It is not appropriate for Nice guidance to be automatically adopted as this would fail to reflect the unique health and social care responsibilities of the committee, the budget available or the additional costs inherent in delivering services in a small jurisdiction.
‘It is also important to note that Nice guidance reports typically set out care or patient pathways presenting an ideal service, not taking into account practicality or affordability of its implementation.
‘In the NHS, where Nice decisions are binding, it is not uncommon for Nice decisions to effectively displace services which at a local level have a higher priority.
‘Such an approach would be hugely detrimental and costly locally, inevitably leading to the restriction of more effective intervention.’
Prescription drugs with a cost per quality adjusted life year exceeding £30,000 are considered in ‘exceptional circumstances’
‘However the committee has consciously adopted a policy where investment decisions on all conditions at all stages of life need be considered in the same way,’ she said.
‘This means that end-of-life treatments are subject to the same decision-making principles and processes as all other treatments.’
Deputy Roffey said islanders were already at a disadvantage as it is harder to get involved in clinical trials for emerging drugs and because they do not have access to the NHS cancer drug fund.
‘The efficacy of the NHS cancer drug fund has been questioned in a 2017 review by King’s College, London, suggesting the majority of the 27 drugs considered failed to show any evidence of meaningful clinical benefit, the fund did not represent good value for patients and society and may have resulted in patients suffering unnecessarily from toxic side-effects of the drugs,’ Deputy Soulsby replied.
‘Since 2016 it has operated under different rules from Nice, but as of yet the effectiveness of the new regime has not been formally evaluated.’
Employment & Social Security, which has responsibility for community-prescribed drugs, approved HSC’s responses.
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