Healthy Skepticism Library item: 18251

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Delamothe T
Half a billion here, half a billion there
BMJ 2010 Jun 10; 340:
http://www.bmj.com/cgi/content/extract/340/jun10_1/c3072

Abstract:

To improve access for patients to costly medicines the Department of Health is looking at joint payment schemes with drug companies (doi:10.1136/bmj.c2832). This week we publish an object lesson in how not to run one.

As James Raftery explains, the UK’s first risk sharing scheme began in 2002 as a ruse to get round NICE’s ruling against use of interferon beta and glatiramer acetate in multiple sclerosis (doi:10.1136/bmj.c1672). The NHS would pay for the drugs, but cost effectiveness would be closely monitored, with an agreement to reduce prices if patients’ outcomes were worse than predicted. However, although outcomes were much worse than predicted (BMJ 2009;339:b4677, doi:10.1136/bmj.b4677), the prices haven’t come down.

The monitoring team says that to make a final judgment on the scheme now would be premature. But Christopher McCabe and colleagues say that its caveats have been known about since the . . .