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Access to new medicines
25/03/2009
The NHS in Scotland will offer staff, patients and the public a better understanding of the processes and decisions involved concerning new medicines, it has been announced.
Making a statement to the Scottish Parliament, Health Secretary Nicola Sturgeon described the 'substantive progress' made over recent months to improve arrangements for introducing new medicines into the NHS in Scotland and the guidance in place to support this.
Today's announcement of a range of measures builds on Scotland's 'well-established and respected arrangements' for the introduction of new medicines through the Scottish Medicines Consortium (SMC) and NHS Quality Improvement Scotland (QIS). The measures include:
- The introduction of patient access schemes in Scotland
- Plans for the SMC to publish the 'modifiers' which it uses when considering new medicines so that special circumstances can be taken into account
- Work underway to produce new guidance for NHS Boards on the end-to-end process for the introduction of new medicines and a new framework to enable a consistent approach to the principles applied for 'exceptional prescribing'
- Health Rights Information Scotland has been commissioned to produce new information for the public on the revised arrangements and guidance which will come into place
Although the statement dealt primarily with access to medicines on the NHS, Ms Sturgeon also announced the publication of revised guidance on situations where patients wish to obtain care privately in addition to their NHS care. This guidance has been issued by the Chief Medical Officer for Scotland, Dr Harry Burns.
Ms Sturgeon told the Scottish Parliament:
"Drug expenditure in Scotland totals 1.22 billion pounds a year. That is a very significant resource - almost 10 per cent of the NHS budget.
"Our objective must be to ensure that this investment supports equitable access to new and innovative medicines on the NHS and that every pound derives the most benefit for patients.
"We must therefore make sure that our decision making processes are robust and that they achieve fairness and a consistency of approach; and that patients, carers and the public have a better understanding of how and why decisions are made.
"All of the developments that I have announced today will - individually and collectively - improve patients' access to medicines on the NHS.
"They will be underpinned by work at national level to develop new IT and data analysis systems to support decision making and, crucially, provide information on medicines uptake and how medicines are being used.
"Arrangements are in place to ensure better networking for those involved in planning and implementing the introduction of new medicines across Scotland in order to share learning and good practice from across the country.
"All of what I have announced today is about improving access to drugs on the NHS.
"My objective is to ensure that we have a system in place that is, from end to end, robust, fair and well understood.
"However I am also today - after consultation - publishing the final revised guidance on 'co-payments' - those situations where NHS patients may wish to include elements of private healthcare, including medicines, in the management of their clinical conditions.
"The guidance is grounded in the fundamental principles of the NHS: namely that NHS treatment must be based on clinical need, not the ability to pay; that NHS care is free at the point of access; that patients can't pay the NHS to top up their care; and that the NHS must not in any way subsidise private treatment.
"However, it also recognises that where a patient chooses to pay for part of their care privately then so long as questions of patients safety, clinical governance, probity and accountability can be answered, they should not necessarily lose out on the NHS care they would otherwise have been entitled to.
"I remain absolutely committed to ensuring the people of Scotland get the best care possible. I believe that by fully addressing the Public Petitions Committee's recommendations, and indeed going beyond them, the progress and series of measures I have described today will improve access to new medicines in the NHS in Scotland."
Draft guidance on 'co-payment' was in issued by the Scottish Government for consultation on December 12, 2008
Since 2008, the Scottish Parliament's Public Petitions Committee has been undertaking an inquiry into the availability on the NHS of cancer treatment drugs. The Scottish Government responded formally to the Committee in September 2008.
'Exceptional prescribing' arrangements are in place in each NHS Board in order to consider the circumstances of individual patients where their clinician wishes to prescribe a drug not recommended by the SMC or NHS QIS following a NICE Multiple Technology Appraisal.
Patient access schemes are proposals put forward by manufacturers to improve the cost effectiveness of a new drug. Arrangements developed by manufacturers which offer a more cost effective option for the introduction of a new medicine. Such schemes can operate when a product has been launched on the market but it is being assessed for introduction into the NHS. An arrangement can be considered between the manufacturer and the NHS to help the NHS secure access to the medicine in a cost effective way. A shortlife working group involving key stakeholders has been considering the basis on which patient access schemes could operate in Scotland through a national framework.