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Cancer Commissioning—at a global and a local level: London Cancer New Drugs Group Annual Meeting
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Discussion points contd.
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Helen Knight pointed out that NICE is only implementing what has been agreed between the Department of Health and the Association of the British Pharmaceutical Industry (ABPI) in the 2009 update to the Pharmaceutical Price Regulation Scheme (PPRS). PASs should not be the norm—they are intended for exceptional cases only. Many new cancer drugs are being approved without the need for PASs. Only if there was no change to NICE guidance following consideration of a PAS application would manufacturers be justified in withholding information they deem to be commercially confidential. NICE always encourages pharmaceutical companies to release as much information as possible to inform the PAS approval process, she added.
Mr Stainthorpe and Ms Knight made it clear that NICE will not provide a standardised PAS or monitor the cost implications for local health economies of new cancer drugs approved within PASs—nor is PASLU currently mandated to assess risk-share schemes outside of its current remit.
Professor McCabe warned of the danger of sub-contracting the legally mandated NICE decision-making process to local or regional bodies. “It is prudent,” he said “to invest whatever resources are required at a national level in order to avoid the potentially catastrophic financial consequences of making a wrong decision.”
Both Dr Catchpole and Professor McCabe said there was a strong case for NICE to audit the cost-effectiveness of PASs on the basis of available evidence.
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Discussion.