New cost rules may prevent patients accessing drugs

The Irish Times - Tuesday, May 8, 2012

FIONA GARTLAND

NEW DRUGS for the treatment of a range of illnesses are likely to become more difficult to obtain after the threshold used to measure their cost effectiveness was halved.

The National Centre for Pharmacoeconomics is charged with assessing drugs coming to the market for cost effectiveness and making recommendations to the Health Service Executive.

Up until recently, the centre judged drugs as good value for money if they cost 45,000 or less for every quality-adjusted life year year of good health delivered to a patient. This figure has now been cut to 20,000 after discussion with the executive, which has been seeking to reduce costs.

Controversial cancer drug Ipilimumab, used to treat malignant melanoma, was released for use last week following a public campaign by patients. It had been costed at 85,000 per patient.

This amounted to almost 150,000 per life year, which the centre for pharmacoeconomics said did not represent good value for money. It recommended the drug should not be released to market at that price. Following negotiation with drugs company Bristol-Myers Squibb, the price of the drug has been reduced.

Dr Michael Barry, clinical director of the centre, said the organisation had been using the 45,000 threshold per life year, but recently the 20,000 limit was being used. He said the centres recommendations go toward the decision on whether or not the drugs are released, but other factors are also taken into account by the HSE.

Its not all about the economic component; medical issues, social issues and ethical issues are considered, he said. We do the economics, but the HSE take the final decision including all four factors.

Dr Tony Holohan, chief medical officer with the Department of Health, said people can still get many drugs that do not meet the thresholds.

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New cost rules may prevent patients accessing drugs