VBP not a magic wand, says ABPI

 The introduction of value-based pricing (VBP) alone will not improve access to medicines, the ABPI says.

The Government has outlined plans to introduce VBP when the current PPRS agreement expires at the end of 2013 in an attempt improve innovation and improve value for money for the NHS.

But Dr Paul Catchpole, Value and Access Director, ABPI, told delegates at the Association’s Annual Conference that there are a number of “strategic issues” which need to be resolved if the new scheme is to be viable for the NHS and the pharmaceutical industry.

When the paper, A new value-based approach to the pricing of branded medicines was issued for consultation last year, Health Secretary Andrew Lansley said the existing scheme “does not promote innovation” and has often seen the NHS “pay high prices that are not always justified by the benefits of a new medicine”.

Dr Catchpole agreed that a new reimbursement scheme needs to have a “better balance between health and industrial policy requirements”, but there are also a number of issues which need to be agreed upon if VBP is to become successful.

“First and foremost, the introduction of value based pricing alone will not be enough to ensure improved access to medicines for patients and thus deliver on what Government has stated as a central objective for a new pricing and reimbursement environment,” he said. “Patient outcomes will only improve if medicines get to and are used by patients. The ongoing structural and commissioning reforms of the NHS alongside the challenging fiscal climate over the next few years can be expected to have a significant impact on the uptake of medicines.”

“Additional measures will therefore need to be built into value based pricing to ensure improved access for patients and further measures outside of value based pricing will also be needed.”

The Value and Access Director says that while there are several mechanisms available which could harness better access to medicines, administrations will need to find solutions which will be appropriate for their own organisation as “one size will not fit all across the UK”.

A worthy aim of a new UK pricing and reimbursement environment will be to avoid increasing inequalities in patient access to medicines across the four nations,” he added.

“It is in the mutual interest of both government and the industry to ensure that there are no further barriers to clinicians deciding whether to prescribe a medicine for the patients once a value based price has been agreed. In other words, the new system will need to ensure that there are no regional or local blocks once a medicine has gained an agreed value based price and so has theoretical national access. The value of a medicine is only realised once the right patients are able to use that medicine.”

Sir Andrew Dillon, Chief Executive of NICE, says his organisation and the ABPI are in agreement that a clear structure needs to be in place to assess value and that NICE should retain its advisory powers.

“There’s actually very little difference in practice between NICE’s and the ABPI’s view,” he said at the same event.

“Medicines do deliver good quality outcomes for many diseases and we need to make sure where that’s the case that we’ve got a system in place for ensuring rapid access.

“We do need to make sure that the process is methodologically sound to generally avoid ‘double counting’. We believe really strongly that it’s essential for the NHS that in the new architecture which is proposed that we retain a clear statement from NICE on the optimum use of drugs.”