NICE TA drugs two-tier system could end, HSC review suggests
A REVIEW by Health and Social Care of access to high-cost NICE TA drugs in Guernsey has come up with a way in which the present two-tier system could be ended, in return for additional funding of about £160,000.
The review of NICE TAs was started by Health & Social Care in the summer of 2023 and has looked at the clinical and financial implications of funding some drugs as well as taking on board feedback from patients and their families.
NICE TAs are medicines that have been subject to a technical assessment by the National Institute of Clinical Excellence in the UK.
The value of these drugs is expressed in terms of their incremental cost effectiveness ratio, or Icer.
HSC is able to fund drugs for local use with an Icer of up to £40,000.
Its latest report includes measures it would need to take in order to assess drugs with an Icer above £40,000.
‘The committee is acutely aware that a two-tier system is currently in place for those treatments with an Icer >£40,000 based on ability to pay or availability of private health insurance, and that this can come at great personal cost to service users and their families,’ said HSC in its report.
‘This situation contradicts the principles of the Partnership of Purpose and... is one which the committee wishes to remedy, when there is the opportunity to do so.’
It said that to make these more expensive drugs available, additional funding would be needed and this would be subject to next year’s budget, said the committee.
The estimated total cost is quoted as being £160,000, which would include a high-cost drug pharmacist to look at the NICE TA recommendations, a data analyst to collect information about prescribing and spending, and the requirement for a database system to record drug details and monitor and report on any NICE TA updates.
Other costs could be funded from existing resources, said the committee’s report.
As part of its research, HSC received a report from CareWatch, an independent consultancy and advisory panel, which showed that islanders had benefited in several ways from the introduction of new drugs and treatments.
CareWatch highlighted seven case studies of people with the conclusion that those who had received a NICE TA drug as part of their treatment were able to feel hopeful and make plans.
‘It is not possible to quantify these benefits on the individuals themselves, their families, or the wider community but the Committee is heartened to hear that NICE TA treatments enabled these islanders to take pleasure from ordinary life events – while experiencing ill-health – that many of us take for granted,’ said HSC.
As well as CareWatch and Deputy Peter Roffey, who led the 2019 requete calling for a review of drugs available, and Policy & Resources, HSC also consulted the Health Equality for All (Heal) pressure group which had lobbied for the change.
Former chairman Mike Read said that the group no longer existed, since the need for it had been overtaken by events.
But some of its members were now part of CareWatch, including Mr Read.
‘I personally think the policy letter is pleasantly succinct and easy reading,’ he said. ‘It is fair, realistic and pragmatic.’
n The CareWatch panel comprises 12 individuals and is looking for up to three new members. For more information go to www.carewatch.gg. It is particularly interested in people who have a strong interest and knowledge of community health and social care, communications and mental health. Those interested in helping us work with HSC to make a difference should email admin@carewatch.gg and ask for an application form.
