A new study has found that the approval of new medicines in England has come at a high cost to the health of many other people due to loss of funding.
New drugs can be a lifeline for millions of patients, but for two decades in England, public spending on them has been accompanied by important counterparts that indicate that the money paid for new drugs could be better used in other health services, according to a new analysis.
Once the National Institute for Care and Excellence (NICE) in England recommends a new drug for patients, the National Health Service (NHS) must pay for it, if prescribed by a doctor. Similar to the Social Security subsidy in Spain.
But with a limited budget, NHS spending on new drugs means other health services are not fundedand this is not always taken into account when policy makers and healthcare professionals weigh the cost-effectiveness of new drugs, according to the study published in the medical journal ‘Lancet’.
With this gap in mind, researchers at British and American universities modeled How this compensation influences the health of the general English population.
“We know that patients benefit from new drugs, but that has a cost to other members of society who may have to give up access to services because funding has to be reallocated to paying for medicines rather than anything else,” Huseyin Naci, associate professor of health policy at the London School of Economics and lead author of the study, explains to ‘Euronews Health’. “They are the invisible people. who lose out as a result of explicitly prioritizing the health benefits we get from medicines.
Counterparts of public spending
Other analyzes have shown that, on average, it costs about £15,000 (€18,000) to pay for a year of health, a measure known as quality-adjusted life years (QALYs).
The researchers used that figure to calculate the number of years of health that could be bought with the 75.1 billion pounds (90.2 billion euros) that the NHS spent on new drugs between 2000 and 2020if the funding had been used for other medical services or treatments.
The authors found that the new drugs made it possible to obtain almost 3.75 million QALYs for about 19.8 million patientsbut if that funding had been allocated to other health services, it could have contributed to 5 million QALYs.
This represents a net loss of 1.25 million years of healthy life. The researchers did not link sacrificed QALYs to any specific medical carebut rather estimated the aggregate health impact, Naci said.
For example, in 2010 NICE recommended the drug ‘trastuzumab’ for patients with advanced stomach cancerand calculated that the value of ‘trastuzumab’ at about 43,200 pounds (51,900 euros) buys one year of healthy life. In the analysis, this translates into 2.88 years of healthy life lost elsewhere.
A NICE spokesperson acknowledged that spending money on new drugs crowds out funding from other health services, but said the agency only recommends new treatments that “offer good value for money for the taxpayer”.
“Each pound of the NHS budget can only be spent once,” the NICE spokesperson said, adding that Even if the agency did not recommend the new drugs, they would likely be prescribed to some patients anyway, leading to disparities in access locally.
Covered Drugs
Part of the problem is that the coverage of NICE prioritizes patients with the most serious unmet health needs who could benefit from new medications, such as cancer patients or those receiving end-of-life care. These medications are often more expensive than other treatments, such as hip or knee replacements.
During the 20 years that the study lasted, two thirds of the evaluations of new drugs corresponded to oncological and immunological treatments, while only 8% went to more common vascular problemssuch as stroke or coronary heart disease.
According to the study, only 19% of the 183 new drugs recommended by NICE had generic or biosimilar alternativeswhich are usually cheaper than brand-name medications.
ADVERTISINGAmitava Banerjee, professor of clinical data science at University College London, said the results indicate that More must be done to encourage the development of drugs for more common diseasesin order to maximize the health benefits of public spending.
In the case of the anticancer drugspolicymakers and researchers should “examine the difference between surrogate outcomes, such as changes in tumor size on imaging, and long-term impact on reducing mortality and improving quality of life“said Banerjee in a statement.
A more holistic view of drug profitability
The results are especially relevant at a time when healthcare systems from the UK and other european countries They debate whether they should pay the new ones anti-obesity drugs which can also help patients treat other health problems.
Health authorities are concerned about the long-term budgetary impact of these drugswhich manufacturers have suggested could be taken for life.
ADVERTISINGThe authors of the study point out that the British Government should consider the possibility of adjust your decision system on the profitability of new drugsand could even push to reduce drug costs so that they are more in line with other medical services.
However, the pharmaceutical industry is likely to be fiercely opposed. Meanwhile, Naci claims that NICE should be more transparent about the possible consequences of prioritizing new medicines compared to other treatments.
“I suspect that NICE committee members might make different decisions if presented with that choice,” Naci said. “We only talk about benefits (of new drugs) as if there were no opportunity costs or unforeseen consequences of those benefits at the population level”.
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