http://news.ft.com/ft/gx.cgi/ftc?pagename=View&c=Article&cid=FT3DFHAHWWC
Jan 26, 2002
Multiple sclerosis patients are to
get expensive drugs on the NHS under a groundbreaking scheme in which the
manufacturers will only be paid in full if the treatment lives up to its
promise.
It will be the first time pharmaceuticals
companies have accepted a payment mechanism that leaves them to carry the
risk of whether the treatment is successful. The model could be applied
to other drugs and treatments.
Under the 10-year agreement, to be
announced shortly, the NHS will pay the full Pounds 6,600-Pounds 12,000
a year price for Beta-interferon and glatiramer acetate. But the health
department said the patients to whom the drugs were given would be monitored
and an assessment made of whether the drug was working. If it was, payments
would be continued in full. If not, they would be reduced on a sliding
scale.
Paul Woodward, managing director
of Schering Healthcare, one of the companies involved in talks, said final
details of the "risk sharing" scheme had still to be settled but that discussions
were at "an advanced stage".
With 13 years' experience of the
product, Betaferon, in the US, he said: "We have good evidence of the efficacy
of the product and what the outcomes for particular types of patients look
like."
The treatment reduces the frequency
of relapses in the minority of MS patients who have the relapsing-remitting
form of the disease. Even for them, it does not work in every case.
Schering and the other companies,
in effect, would be helping ensure the right patients were selected for
treatment and then guaranteeing the drug's performance against agreed outcomes.
Mr Woodward said: "In England and Wales we think between about 7,500 and
9,000 patients would benefit in total, not all the 84,000 patients with
MS."
If over the planned 10-year life
of the agreement a better treatment emerged, he said, "the scheme would
probably be put to bed".
One senior government health adviser
said: "This could well be a model not just for the purchase of other drugs
but for buying other types of health care. It could have all sorts of applications."
It is not yet clear whether all four
of the manufacturers - which include Biogen, Teva and Serono - will take
part. But Glyn Wright, managing director of Teva, which makes glatiramer
acetate, said the scheme would "reduce the risk for the NHS that the treatments
will underperform and put the risk back on the companies. We are hopeful
of being able to reach agreement."
The deal has been put together after
the National Institute for Clinical Excellence ruled that the treatments
were not cost-effective enough for the NHS to adopt them routinely. It
urged the health department to find a way of delivering them more cost-
effectively.
The Multiple Sclerosis Society said
the arrangement would be "good news for many people with MS". It would,
however, come too late for those who had become too disabled to qualify
for treatment while Nice had been making its assessment.
Copyright: The Financial Times Limited
By NICHOLAS TIMMINS