A brand new fund to fast-track affected person entry to probably priceless new medicines might incentivize the pharmaceutical trade to develop excessive priced medicine for uncommon ailments with weak proof on medical advantages.
Well being economics and coverage lecturers from the London Faculty of Hygiene & Tropical Drugs (LSHTM), writing within the Journal of the Royal Society of Drugs, warn that if the NHS England Revolutionary Medicines Fund (IMF) is just not carried out appropriately, it dangers disincentivizing the era of important proof and will shift the monetary burden from the pharmaceutical trade to the general public funds.
The IMF operates on comparable phrases to the Most cancers Medicine Fund (CDF), with a hard and fast annual price range of £340 million, equal to the CDF. Lead creator Dr Aris Angelis, Assistant Professor in Well being Economics on the Division of Well being Providers Analysis and Coverage at LSHTM, mentioned: “Whereas we’re broadly supportive of the eight guiding rules of the IMF, we consider their operationalization is described in inadequate element and with out absolutely leveraging the CDF expertise.”
The authors say the worth of the CDF to society stays unproven, with considerations about lack of transparency in the price of medicine and the time interval throughout which they continue to be beneath the CDF scheme.
The authors additionally query why the CDF and IMF schemes, also called ‘managed entry’ schemes, ought to solely exist for medicines and no different sorts of interventions. “The necessity to think about non-medical interventions is especially related in illness areas akin to most cancers, for which entry to prime quality radiation and surgical remedy are essential to enhancing outcomes,” mentioned co-author Dr Ajay Aggarwal, Affiliate Professor at LSHTM and medical oncologist.
One other concern the authors spotlight is the entry standards for the ‘most promising’ medicines into the IMF, which, they are saying, ‘are at the moment critically missing intimately.’
If the IMF is to efficiently foster early entry to clinically efficient, protected and cost-effective medicines, say the authors, its operational particulars and mechanisms in place should be rigorously designed.
The IMF, just like the CDF, ought to be an distinctive path to affected person entry whereas offering the requisite proof, primarily from randomized managed trials, for lowering uncertainty a few drug’s medical and cost-effectiveness.”
Dr Aris Angelis, Assistant Professor in Well being Economics, Division of Well being Providers Analysis and Coverage at LSHTM
The authors additionally say the notion of alternative price should not be ignored. “IMF funding may all the time be used for different well being companies and applied sciences with robust proof on effectiveness and value-for-money which may enhance general inhabitants well being,” mentioned Andrew Briggs, Professor of Well being Economics at LSHTM.
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Journal reference:
Angelis, A., et al. (2023) The Revolutionary Medicines Fund: a common mannequin for sooner and fairer entry to new promising medicines or a Computer virus for low-value creep?. Journal of the Royal Society of Drugs. doi.org/10.1177/01410768231192476.