More health is being lost than gained from NHS spending on new medicines

New drugs approved by NHS spending watchdog NICE may have helped some patients, but their introduction has come at a heavy cost to the health of many others due to loss of funding in other areas of care. a new study Lancet reveals.

Analysis shows that between 2000 and 2020 in the UK, new medicines delivered 3.75 million more years of full health (1) at a cost of £75 billion. However, directing this funding to existing NHS services could potentially deliver 5 million years of full health.

This is a result of NICE’s cost-effectiveness threshold for new medicines, set at £20,000 to £30,000 per additional year of health, being higher than the typical NHS spend of £15,000 for the same outcome (2). This allows companies to charge higher prices than the NHS pays to deliver similar health benefits using existing treatments and services. When expensive new medicines are used on the NHS, funds are diverted to treatments and services that provide better value for money and potentially greater health benefits.

Hüseyin NaciAssociate Professor of Health Policy at the London School of Economics and Political Science (LSE) and lead author of the paper, said: “New medicines can be a lifeline for patients with significant unmet clinical needs. But innovative medicines are expensive and their cost does not always justify the benefits they offer.”

“After over a decade of underinvestment in the NHS, it may no longer be justifiable to have a NICE threshold that does not reflect the amount the NHS needs to spend to produce health. “Lowering the threshold will allow the NHS to negotiate better prices for new medicines, taking into account not only the benefits to patients taking these medicines, but also the impact on other NHS users who may lose out through reallocation of resources.”

Irene Papanicolas, Professor of Health Services, Policy and Practice at Brown University and one of the study’s authors, said: “Our findings reflect the tight budget of the NHS. In this environment, balancing funding from existing services to pay high prices for new medicines is a challenge to health systems where there is greater budget flexibility.” “It may have a more negative impact on public health.”

Beth Woods, Senior Research Fellow at the Center for Health Economics at the University of York and one of the study’s authors, said: “This study shows that there is a need to reform medicine pricing policy in England to better serve people’s health needs.” All patients served by the NHS.

A recent agreement between the UK government and the pharmaceutical industry commits NICE to maintain the cost-effectiveness threshold until 2029.

The researchers recommend that trade-offs in funding decisions be more clearly acknowledged and communicated to patients and the public, especially when prioritizing new drug recipients means others may miss out on vital care due to loss of funding in other areas of care.

Researchers from the London School of Economics and Political Science and York University in the UK and Brown University in the US evaluated the impact of NICE’s recommendations for new medicines on public health between 2000 and 2020. Using drug sales data, the researchers estimated how many patients were taking these drugs. They then compared the health benefits of these drugs to other treatments that could be funded with the same money to see their overall impact on population health.

The researchers acknowledged some limitations in their analysis. They noted that the data in the NICE reports was incomplete due to corrections. Additionally, a small number of new drugs were excluded from the study due to gaps in the available data. The team also had to make assumptions about how long patients would stay in treatment when estimating the number of people who would receive the new drug.