Funding of more expensive NHS approved drugs and treatments likely to be delayed until at least 2026

Friday 18 October 2024

Spending pressures mean that more expensive drugs and treatments that have been approved in the UK will not be made available in Guernsey under proposals made by Health & Social Care.

It has reviewed the potential for expanding the range of NICE TA drugs and treatments beyond what are currently supported.

The committee will spend £5.1m. this year and this could rise to £7m. in 2025 even without any policy change as new drugs and treatments come within the current thresholds.

“In shaping its recommendations to the States for future drug funding policy, the committee has been cognisant of the complex and emotive nature of this topic and of the potential benefits that extending the range of NICE TA drugs and treatments available could have for the quality of life and wellbeing of people in our community experiencing poor health,” its States report says.

“As is the often challenging nature of many of the decisions within Health and Social Care, it has been necessary for the committee to weigh-up this consideration with its wider duty to make recommendations to the States which ensure both the effective use of public funds, and the resources entrusted to it.

"Likewise, it has considered the principles of the Partnership of Purpose, most notably the principle of fair access to care and is fully aware that prior to their recent implementation, some NICE TA drugs and treatments were only available to those residents who were able to access them on a private basis. This remains the case for those treatments with an ICER value above £40,000 which are currently unfunded.”

"A pragmatic way forward"

It has proposed what it says is a “pragmatic roadmap” while remaining “committed to the principle of moving towards funding all TAs when the  operational and financial constraints better allow for this”.

HSC has recommended that the position of funding NICE TAs to an ICER value up to £40,000 should be maintained in its policy letter which will be debated soon.

“This position is still an improvement as NICE are continually assessing new drugs and treatments under the current threshold for funding of £40,000 ICER i.e. the list of drugs and treatments is not static, and neither will it be static in the future.”

In 2012 it was made mandatory in law for health service commissioners in England to fund those drugs and treatments recommended via the NICE TA programme.

Full access to drugs and treatments with a NICE TA are available in Jersey.

Guernsey adopted a phased implementation in 2020 taking it through to 2023 for treatments up to £40,000, a policy that has continued since.

Since its original Policy Letter was debated, the committee says it has made available to the community 149 NICE TAs, benefiting an estimated 886 patients, at an estimated cost of £4.3m.

For 2025 it originally requested £8m. for this area.

Policy & Resources' Budget recommends £6m. instead, funding that will exhaust the Guernsey Health Reserve.

It has put aside another £950,000 in a reserve in the event that cost expectations are more inline with HSC’s calculations.