1 Jul 2019

UK’s drug-buying agency CEO: Why we like to say ‘yes’

From Checkpoint, 5:08 pm on 1 July 2019

While more than 100 medicines sit on Pharmac's waiting list, some for 10 years, the UK's own agency - NICE - doesn't have a waiting list. 

Watch: NICE boss Sir Andrew Dillon is visiting NZ and sat down for his only interview here with Guyon Espiner

It's ranked one of the best OECD countries in terms of access to medicines.

On the other hand, New Zealand is ranked near the bottom - something that's sparked intense pressure in recent times from patients with everything from cancer to rare disorders who say they're missing out and the system has to change.

So how does the third-ranked country, the UK, run its agency - the National Institute for Health and Care Excellence - or NICE? 

For starters, NICE releases almost all of its assessment data including board minutes. Pharmac does not. 

NICE approves more than 80 percent of the applications to fund new medicines. Pharmac approves fewer than a quarter.

The greatest difference, however, is speed. While more than 100 medicines sit on Pharmac's waiting list - some for five or even 10 years - NICE has no waiting list at all.  

NICE chief executive Sir Andrew Dillon is visiting as a guest of Medicines New Zealand, which represents drug companies and has also met with government ministers and representatives from Pharmac.

He told Checkpoint that for cancer treatments at the moment "our target is to send the signal out within 90 days of a drug receiving its licence". 

He said hitting that target was dependent on a number of variables but didn't always happen.

"We plan to extend that 90-day target to all kinds of drugs over the next couple of years or so."

Most of the times, he said, the agency said yes to most drugs.

"If you look back over 20 years, we can find value in the new drugs that we look at 80 percent of the cases ... it's a bit less for cancer treatments," Sir Andrew said.

"If you look overall, the great majority, eight out of 10 of the things that we look at we can say something positive about. So, it's only a minority where either the clinical data wasn't strong enough or we can establish a price with the company that makes the treatment."