NICE 'Missed Golden Opportunity' to Encourage Innovative Drugs – Medscape

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Peter Russell
February 07, 2022
Changes to the way medicines and other health technologies are evaluated by the National Institute for Health and Care Excellence (NICE) have been criticised as “minor tweaks rather than bold reforms”.
The Institute of Cancer Research (ICR) says that NICE has “passed up a golden opportunity to ensure its evaluation methods support approval of the most innovative, potentially game-changing drugs”.
Updated criteria for new evaluations, which came into effect on February 1, would give patients earlier access to innovative new treatments, NICE said, by taking account of technological advances in healthcare. It said the new guidance would allow greater flexibility over decisions about value for money, and its independent committees would have more flexibility in cases where it was difficult to generate enough evidence.
Prof Gillian Leng, NICE chief executive, said the aim was to be “at the forefront of delivering access for patients in the NHS to valuable, evidence-based innovative medicines, medical devices and diagnostics”.
However, the ICR said reforms to the way NICE will assess drugs for the NHS in England and Wales “fell short of what was needed” and could even make access to new cancer drugs harder.
Cancer experts at the ICR said more needed to be done to encourage drugs with innovative mechanisms of action, speed up approval of new drugs, and remove barriers to drug approval for rare diseases, such as children’s cancer.
They warned that ‘minor tweaks’ proposed in some areas would not be enough to incentivise pharmaceutical companies to take the risks needed to create truly innovative new treatments – and that patients with cancers of unmet need (those that are harder to treat) would continue to miss out.
The ICR also called on NICE to conduct a pilot study to assess the impact of one proposed change, switching end-of-life criteria for a disease severity modifier.
Otherwise, there was a risk that cancer patients at the end of their lives could be denied new treatments that might extend their time with loved ones, it said.
Prof Kristian Helin, chief executive of the ICR, said: “We believe NICE has missed a golden opportunity to improve the lives of people with cancer by making it easier to access exciting new treatments on the NHS.”
He added: “We want to see an appraisal system that incentivises the discovery and development of the most cutting-edge new treatments and technologies, and provides hope for patients with cancers that are rare or especially hard to treat.
“We believe that NICE should be favouring the most scientifically innovative drugs, and levelling the playing field by making it easier for children with cancer, and other patients with rare diseases, to gain access to new treatments. And NICE should be establishing early measures that help to predict longer survival, so it can make innovative new treatments available to patients more quickly.”
Prof Helin said he wanted NICE “to carry out a full evaluation of the potential impact of replacing the end-of-life modifier with a disease severity modifier before implementing this change, to ensure it does not have unintended consequences or disadvantage certain groups of patients”.
NICE said it would work to identify areas in its evaluation criteria that “might include processes to facilitate rapid entry to managed access, and to manage technologies with multiple indications, methods issues for digital, genomic and antimicrobial technologies, and further methods issues, such as the societal value of health benefits in severe diseases and health inequalities”.
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Cite this: Peter Russell.  NICE ‘Missed Golden Opportunity’ to Encourage Innovative Drugs – Medscape – Feb 07, 2022.
Journalist, Medscape Medical News

Disclosure: Peter Russell has disclosed no relevant financial relationships.
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