Nice blight bypass for drugs runs out of money

A fast- track scheme to provide drugs on NHS runs into a funding row. Health ministers have approved a fast-track system to decide which new drugs the National Health Service should provide, but have found themselves locked in a row over funding.

Jane Kennedy, the junior health minister, appeared almost to invite legal challenges over the provision of costly new cancer drugs when she said patients should appeal against decisions where a primary care trust refuses to fund them and the patient believes that the decision is "inappropriate".

Ministers announced approval of a system aimed at ending, or at least reducing, "Nice blight" - the situation where hospitals and primary care trusts refuse to fund new treatments until the National Institute for Clinical Excellence has pronounced on them.

Although primary care trusts are told they do not need to wait for Nice guidance when a drug is licensed, and have been specifically told they should not refuse such treatments purely on grounds of cost, Nice acknowledged yesterday that "both patients and primary care trusts tell us PCTs will not pay until they have seen our guidance".

Under the new system, Nice will cut out some of its consultation processes when conducting appraisals that compare one treatment with another. It will also start its assessment of whether significant new drugs are cost- effective in parallel with the licensing process.

That should cut the typical appraisal time from about 18 months to six, but more importantly, produce a decision on whether the NHS should supply the treatment within about eight weeks of the licence being granted rather than months or years later.

Fourteen cancer drugs, some of which cost between £10,000 and £40,000 for a course of treatment, will be the first to be put through the new routine.

But while Patricia Hewitt, the health secretary, has told NHS trusts that when doctors recommend it on a named patient basis they must fund Herceptin, the new treatment for early breast cancer - even though the drug has yet to be licensed - Ms Kennedy made clear that ruling did not apply to half-a-dozen other cancer drugs that Nice is to consider but which, like Herceptin, have yet to be licensed.

But she said that "if a patient believes the primary care trust has made an inappropriate decision they can appeal that decision".

The Association of the British Pharmaceutical Industry welcomed the new process, but said it wanted to study the details. "There are sometimes limitations on what evidence is available on clinical and cost-effectiveness at the time of a medicine's launch," it said.

It also remained "vital" the guidance was "properly funded and implemented without delay by NHS trusts, Andrew Curl, the association's deputy director said, particularly given evidence that even when guidance is issued, about half of trusts failed to implement it.

Ms Kennedy said increases in NHS spending gave care trusts the cash for new treatments. But Andrew Lansley, shadow health secretary, said that unless financial problems were resolved, "the benefits will be limited".

The drugs on the NICE blight bypass list are: Docetaxel (Taxotere) for early breat cancer, Paclitaxel (Taxol) for early breast cancer, Rituximab (Mab Thera) for early stages of non- Hodgkin's lymphoma, Bortezomib (Velcade) for multiple myeloma and Trastuzimab (Herceptin) for early breast cancer.

http://news.ft.com/cms/s/60f0279a-4cd8-11da-89df-0000779e2340.html