Deputy explains why he was only one to vote against new drug policy
THE only deputy who voted against proposals to fund a wider range of drugs and treatments has explained why he did so.
Shane Langlois said it was because he thought there were inconsistencies in the medicine-approval process that had not been properly explained to deputies.
He was also concerned that funding for the proposals had not been adequately secured.
Deputy Langlois said that, despite his vote, he was not against increasing healthcare spend in principle.
‘The idea you can agree to spend £8m a year without even proposing a source of funding is unacceptable,’ he said.
‘If there had been some indication of how to pay for it, other than raiding reserves, I’d have been more in favour of it.’
Deputy Langlois said that, on paper, Guernsey and the NHS use the same method to assess the cost-effectiveness of medicine or treatments, but despite this there were unexplained differences in availability of medicines that had not been sufficiently explained to deputies by Health & Social Care.
He therefore felt deputies did not have enough context to vote on such an important matter.
‘It is quite a subtle issue and there is no sustainable funding and no explanation for why the existing system doesn’t fund certain drugs that would be deemed cost-effective by the NHS.
‘I’m supportive of achieving parity with the UK for treatments, however a viable long-term funding mechanism has to be agreed beforehand.’
In particular, he was concerned that the method used to evaluate whether a treatment was cost-effective was not transparent enough.
‘The reasons we do not currently have parity, when on the face of it the Health & Social Care and NHS guidelines cite a similar treatment threshold, are not exactly crystal clear.’
He suspected that perhaps the UK was less draconian when measuring cost-effectiveness, compared to Guernsey’s ‘strict application of a cut-off’ which could explain the discrepancy.
‘We needed more of an explanation. Was treatment denied because of HSC’s policy or our interpretation of the policy?’
When asked about the differences described by Deputy Langlois, HSC president Deputy Heidi Soulsby explained that while the NHS funds all Nice [the National Institute for Health and Care Excellence] technology appraisals, whatever the cost, Guernsey has its own evaluation process.
‘Our approval process has been undertaken by clinicians through the Prescribing and Formulary Panel who consider the evidence and decide based on that, which will include Nice guidance.’
