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Pharmaceutical Pricing and Reimbursement in the United Kingdom, 2008
Decision Resources, Inc., Dec 2008, Pages: 40
The pharmaceutical industry has long criticized the slow uptake of new medicines in the United Kingdom. Beginning January 1, 2009, the U.K. government plans to implement measures to accelerate and widen access to innovative drugs. However, the pharmaceutical industry will be expected to adapt to a more flexible pricing environment. In this report, we analyze the potential impact of the changes unveiled in November 2008. Get the Answers You Need to Shape Your Strategy
- The United Kingdom is one of the most accessible of all European pharmaceutical markets in terms of product registration, price setting, and reimbursement. How do U.K. prices compare with prices in other major markets? What are the procedures for price setting in the United Kingdom? How do manufacturers secure reimbursement for their products?
- The U.K. government uses a more limited range of cost controls than most of its European neighbours. How has the government used price cuts and freezes to curb spending? What measures have been implemented to stimulate the use of generics? How are prescribing budgets and audits used to modify physicians’ prescribing behaviour?
- The National Institute for Health and Clinical Excellence (NICE) has become a very powerful influence on medical practice in England and Wales. How has the institute’s activity evolved over the years? How does the pharmaceutical industry view NICE? What measures have some companies adopted to overcome NICE’s rejection of their drugs? What changes has the government proposed to minimize any negative impact on access to medicines from NICE’s activity?
-The government’s recently unveiled reform program includes some very welcome developments for the pharmaceutical industry. What measures are designed to accelerate the uptake of innovative therapies? What changes are expected to improve the reimbursement prospects of end-of-life treatments? What is the government doing to widen access to therapies not endorsed by NICE? In return for these concessions, how will the government require greater pricing fl exibility from the pharmaceutical industry? Scope
-Organization and funding of the U.K. healthcare system: history of the National Health Service (NHS); healthcare spending in the United Kingdom; funding of the NHS; role of private healthcare in the United Kingdom; recent organizational changes to the NHS.
-Pharmaceutical prices: comparison of prices in the United Kingdom and other major markets; pricing of branded prescription drugs based on new active substances, branded prescription drugs based on established active substances, and generic drugs; pricing in the hospital sector.
-Cost-containment measures: price cuts and freezes; reimbursement restrictions; prescribing budgets and audits; local formularies; use of generics; parallel imports; patient copayments.
-Health technology assessment: creation of the National Institute for Health and Clinical Excellence (NICE); industry criticisms; government response to parliamentary review of NICE; focus on oncology; risk-sharing and cost-sharing agreements.
-Outlook for the U.K. pharmaceutical market: key trends; growing industry disillusionment with the U.K. market; promise of reform in draft NHS constitution; improving patient access to innovative medicines; implications for the pharmaceutical industry.
Key reforms announced in November 2008:
-A 3.9% price cut effective February 1, 2009, followed by a 1.9% price reduction on January 1, 2010; modest price increases from 2011 through 2013.
- Proposed introduction of generic substitution by pharmacists beginning January 1, 2010.
- Measures to allow National Health Service (NHS) patients to receive parallel private treatment with drugs not covered by
the NHS.
- Introduction of a new technology appraisal process for expensive end-of-life treatments that are not deemed cost-effective by the general standards of the National Institute for Health and Clinical Excellence (NICE).
- Establishment of a unified horizon-scanning process.
- A guarantee that the requirement for PCTs to fund therapies approved in NICE technology appraisals will continue when such guidance is later incorporated into clinical guidelines.
- Measures to update good practice guidance regarding the funding of therapies that have not been appraised by NICE.
- Creation of pilot prescribing incentive programs to promote faster uptake of innovative medicines.
- Exercise to determine how established initiatives could be used to improve the uptake of new drugs.
-Measurement of the comparative uptake of clinically effective and cost-effective medicines (beginning with several therapies positively appraised by NICE) at local, national, and international levels.
-Creation of patient access schemes to improve access to drugs that NICE initially judged as lacking clinical effectiveness and/or cost-effectiveness.
-Introduction of a flexible pricing system for medicines reviewed by NICE, with the prospect of postlaunch price increases or cuts.
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