PhRMA released a new analysis of the impact from patient access restrictions in the UK due to recommendations made by the National Institute for Health and Care Excellence (NICE).
New analysis of patient access restrictions in the United Kingdom.
Today, PhRMA released a new analysis of the impact from patient access restrictions in the UK due to recommendations made by the National Institute for Health and Care Excellence (NICE). NICE is the government agency charged with recommending if a medicine should be available to patients in the UK’s public health insurance program, the National Health Service.1
Only 39% of new medicines launched globally between January 1, 2017, and December 31, 2021, are recommended by NICE for coverage, and only 13% are recommended for all approved uses. Patients in the UK face access restrictions on a higher share (66%) of new medicines covered by public health insurance than do patients in the United States, Germany or France.
Patient access depends heavily on coverage and reimbursement by public health insurance in many countries. In the United Kingdom, patients face access restrictions even when a medicine is covered by public health insurance (e.g., NHS England) because NICE can recommend that only some approved uses should be reimbursed.
The effect on cancer patients can be particularly stark due to the high degree of ongoing innovation in cancer treatments. Far fewer patients in the UK access new cancer medicines that are recommended by NICE with restrictions — for instance, the report shows that the uptake rate of these new cancer medicines in the UK is only 6% of the uptake rate in the United States, 38% of the uptake rate in Germany, and 43% of the uptake rate in France.
The new report shows the impact of policies that let governments act as gatekeepers between patients and new treatments. Government “negotiations” for coverage and pricing of new medicines can severely restrict access for patients, even in high-income countries with well-established and timely regulatory approval processes for safety and efficacy.
Click here to download the full report.
1. NICE recommendations apply to the National Health Service (NHS) in England, Wales and Northern Ireland.
