HSC confirms funding delay for new life-changing drugs

HSC has said that while it is acutely aware of the disparity between the provision of National Institute for Health and Care Excellence’s Technology Appraisal treatments in Guernsey and the UK, and the need to close that gap, Covid-19 had influenced the timescale – originally set for within two years.

Year 1 of the introduction of drugs and treatments with an incremental cost-effectiveness ratio of up to £30,000, will now begin in 2021, and Year 2 will follow 12 months later.

Campaign group Health Equality for All chairman Mike Read instigated the response when he questioned the eight months ‘political silence’ from HSC since funding was backed in January.

He said while he appreciated the work being done to combat the coronavirus, quicker action was needed considering the acknowledgement back in August 2019 of a significant disparity in treatment for the more than 3,000 islanders that was too great to be justified – and one that he said was worsening by 700 patients each year.

‘We are already a year on from HSC’s publication of a sobering review of our health care system,’ he said.

‘Eight months on from the near unanimous [38-1] approval by the States for change, yet nothing has changed.’

Covid-19 understandably had been the key focus, but Mr Read added the island was now more than 100 days since our last Covid-19 case, let alone death.

‘The Civil Contingencies Authority and HSC are planning for a potential second wave and a seasonal flu epidemic, as they do every year. But what about the thousands and thousands of ordinary Guernsey folk who will get sick, are sick, are fighting for their lives on sub-optimal treatments, waiting for our States to deliver for them?

‘The political silence has been deafening.’

HSC offered, in response, its reasoning behind the delay and said while it understood the need to move at pace, there were now more unprecedented and unavoidable concerns that had not been planned for.

‘The Covid-19 pandemic, the biggest public health crisis the world has faced since the Second World War, has impacted on how quickly other priorities can be taken forward,’ the spokesperson said.

‘Inevitably our staff, many of whom are precisely the same staff involved in working on Nice TAs, have had to dedicate themselves to the pandemic response.

‘While Guernsey has thankfully been Covid-free for several weeks, the risk remains and we must continue to analyse new and changing data, plan for a range of future developments, including changes in how we manage our borders and the possibility of a second wave, and make quick decisions that impact on the lives of everyone in our community.’

HSC added it hoped there would be recognition for the improvements they had made so far.

‘Already new drugs are available when previously they weren’t, such as Orkambi and Symkevi, both for people living with Cystic Fibrosis,’ they continued.

‘The committee is making preparations to ensure its successors in the next political term can continue to move forward with implementing NICE TAs as soon as possible, mindful that they too are likely to have to continue prioritising the Covid-19 response, at least initially.

‘We are hopeful that the first phase, which was described as Year 1 in the policy letter and would see the introduction of drugs and treatments with an incremental cost-effectiveness ratio of up to £30,000, will begin in 2021, and Year 2 will follow 12 months later.’

In 2018 HSC was urged to review their drugs policy, on the back of this there was a requete followed by an extensive review and public consultation, the results of which were published in August 2019.

The review found that of the 480 NICE TA drugs routinely available in the NHS only 320 were offered in Guernsey and while clinicians were able to make an individual funding request, on a case by case basis for the 160 unavailable treatments, not one of the 43 requests made received approval or the required funding.

The States voted in January their approval of funding for a phased introduction of 93 of the 160 unavailable NICE TAs over a two year period in a 38/1 unamended landslide.

Year one cost was due to be £5.6m. and year two £8.3m, with a review to follow to examine its impact, future funding options and whether Guernsey should extend treatment to include all NICE TAs.