16 March, 2002
I was moved by Dyson's account of coming to terms with his wife's diagnosis of multiple sclerosis and the difficulties of obtaining access under the NHS to one of the three beta interferon products licensed for this indication.(1) Only 2% of people with multiple sclerosis in the United Kingdom are receiving interferon beta, compared with 12-15% elsewhere in Europe and an even higher proportion in the United States. As I work for a company that manufactures an interferon beta product, albeit different to the one that was the subject of Dyson's personal view, I would like to provide some reasons why drug prices may differ between countries.
When our interferon beta (Betaferon, interferon beta-1b) was launched in the United Kingdom and Europe in 1995, worldwide prices were comparable. Huge currency differences have developed subsequently across Europe, with the pound being strengthened by a third to the Deutschmark since 1995.
Prices of branded pharmaceuticals to the NHS are controlled by the government. Schering Health Care Limited complies with the pharmaceutical pricing regulation scheme, negotiated between the Department of Health and the Association of British Pharmaceutical Industries. The scheme does not guarantee that the manufacturer makes any profit on a particular product. This differs from other European countries, where reimbursement can vary between categories of treatments. In Germany interferon beta is fully reimbursed through government insurance schemes; in Italy the price depends on the number of units sold.
The pharmaceutical industry also funds additional services in the United Kingdom as a result of underresourcing in our health system: we have fewer than one fifth the neurologists per head of population than in most other developed countries.(2) For example, specialist nurses for patients with multiple sclerosis, supported wholly or partly by industry, make a huge contribution to the care of people with the illness, including the vast majority who do not receive any interferon beta or other disease modifying treatment.
As part of our compliance with the pharmaceutical pricing regulation scheme, the NHS price of Betaferon had two modulations last year, and in August was £7263.97 per patient per year. This is not so different to the price Dyson is paying for interferon beta from Australia.
Jacqueline C Napier, associate medical director.
Schering Health Care, Burgess Hill, West Sussex RH15 9NE
1. Dyson A. The price isn't right. BMJ 2001; 323: 407 [Full
Text]. (18 August.)
2. Kmietowicz Z. United Kingdom needs to double the number of neurologists. BMJ 2001; 322: 1508 [Full Text].
© BMJ 2002