Primary care trusts are “misconstruing” official drugs guidance in order to restrict access to treatments, a coalition of patient bodies has warned.
The independent group of patient organisations called Patients in NICE, which works with the National Institute for Health and Clinical Excellence, also claims PCTs are applying “one-on one-off” policies in order to ration treatments and save money.
Earlier this month, HSJ revealed NHS medical director Professor Sir Bruce Keogh had warned PCTs against decisions to restrict treatments “made solely on the basis of cost”.
Multiple Sclerosis Society head of policy and campaigns Laura Weir, who was appointed in July as Patients in NICE chair, said patient groups were “really concerned about access to treatment”.
She said some commissioners were going beyond their normal role and “grouping together to create regional prescribing policies”. She said these policies often have “significant inaccuracies and contradict guidance from regulators”.
For example, PCTs in the West Midlands have commissioned independent guidance from the Midlands Therapeutic Review Committee for drugs yet to be ruled on by NICE, including multiple sclerosis drug Sativex.
Sativex was licensed in 2010 by the Medicines and Healthcare products Regulatory Agency, which judged that its “benefits outweigh the risks”.
But MTRAC’s commissioning guidance said the drug “cannot be recommended for prescribing because of inadequate evidence for efficacy and/or safety”.
Ms Weir said: “They are making decisions about safety and efficacy – that isn’t their role. At best, guidance is being misconstrued and patients are being denied access to treatment.”
But MTRAC member and director of medicines evaluation at Keele University Anke Mans said the committee merely provided guidance and commissioners could decide how to act on it.
Elsewhere, commissioners were even restricting drugs recommended in NICE technology appraisals by requiring “ad hoc exceptional funding forms” to be filled out, Ms Weir said.
She said in some cases PCTs were operating a “one-on one-off” policy on a NICE-approved drug for rheumatoid arthritis, meaning only a fixed number of patients could be treated.