Health & Social Care is behind its original schedule for funding more drugs and treatments due to the coronavirus pandemic, but says it is now in a position to begin work to roll out the first tranche of drugs, likely to be oral ones administered in the community.
There will be an incremental implementation of the States’ decision in January to increase the range of National Institute for Health and Care Excellence’s technology appraisal drugs and treatments to Bailiwick residents, beginning with 16 drugs introduced to the white list and hospital formulary.
HSC hopes to make available the remainder of the drugs with an incremental cost-effectiveness ratio per quality-adjusted life year equal to one year of life in perfect health for a patient of up to £30,000 during the first half of 2021.
HSC president Heidi Soulsby said following the States’ decision that to focus limited resources on the Bailiwick’s response to the Covid-19 pandemic, established processes for reviewing new drugs had continued throughout the year.
‘I know that persuading the legal departments in drug companies to write bespoke agreements for Guernsey can be challenging and takes a considerable amount of time,’ she said.
‘Making up to 20 new drugs available for islanders by the end of this year does not sound many to some.
‘However, it is worth noting that two drugs included in this number are for cardiac patients and we expect in the region of 1,450 patients to benefit from them.’
A range of drugs recommended by Nice TAs and by Nice highly specialised technologies guidance, other high tech products, as well as non-Nice TA products, have been made available to islanders at NHS discounted prices since the States vote.
Cases have been considered on an individual basis through the individual funding request process, however, no request from a doctor for a Nice-approved TA drug has been declined since the States resolution was made.
Mike Read, chairman of campaign group Health Equality for All, welcomed the update.
‘After [a Guernsey Press] story back in August, we made sure the impact of the lack of progress by HSC in implementing the States approval of Nice TA drugs and treatments was understood by prospective new deputies and it became a topic of discussion in the run-up to the election,’ he said.
‘A number of helpful and positive discussions with senior staff and members of the HSC have followed.
‘Heal are very grateful and pleased with the engagement we have had and that HSC have formally announced that work has begun on implementation.
‘Significantly, about 20 oral drugs which can administered by clinicians in the community will be among the first targeted by HSC and should benefit in the region of 1,450 patients by the end of this year – this is great news for Guernsey.’
Medical director Dr Peter Rabey added that more work still needed to be done.
‘It is not possible to adopt all Nice TAs in one go as each drug will need individual, technical consideration to ensure that clinicians are supported in accessing and prescribing the drugs appropriately and that the Bailiwick receives value for money through the creation of a specific legal, commercial agreement for each new drug available via an NHS patient access scheme with each manufacturer,’ he said.
‘It’s a complicated process, but one that HSC is committed to and will be starting in the next few weeks with the view that some new drugs will be available to islanders by the end of this year.’
HSC’s aim is to close the provision gap of Nice TAs drugs and treatments in Guernsey compared to the UK, originally set for within two years.
Year one cost was due to be £5.6m., year two £8.3m, and a review following this to examine its impact, future funding options and whether Guernsey should extend treatment to include all Nice TAs.