The Department of Health has been criticised for undermining the independent role of the National Institute for Clinical Excellence and 'chickening out' of the body's controversial decisions after it revealed it was negotiating to pay for trials of drugs used in the treatment of multiple sclerosis, despite NICE maintaining they are not clinically or cost-effective.
Although NICE will not be issuing any guidance on the use of beta interferon and glatiramer for MS until at least December, its preliminary recommendation is against making the drugs available.
But the DoH last week announced it was in discussions with manufacturers about trials of the drugs involving up to 10,000 patients, which could last for several years. A spokesperson said: 'Our discussions are looking at a range of options, including the possibility of a 'risk -sharing' scheme in which the drug would be funded for relapsing-remitting MS patients.'
It would mean that if the drugs were working, payment to the four companies which make beta interferon would continue, but would be reduced on a sliding scale if they were not effective.
Policy analysts have said, however, that the decision goes back on assurances about the independence of NICE. York University professor of health economics Alan Maynard said:
'How are we going to make choices on the back of evidence or political foible? If politicians want to override the choice, they must be seen to be doing it.
'They have found the MS Society far too political a lobby.
The MS Society is a very wellorganised lobby, as is the pharmaceutical industry.'
Professor Maynard said the government had failed to stick to its guns when a controversial decision was made: 'Here is one and they have chickened out.'
He added: 'One must predict there are going to be other drugs that are not value for money for the NHS, so this will re-occur.'
NHS Confederation policy director Nigel Edwards said: 'The manifesto said they were going to make NICE recommendations binding, so why are they suggesting there needs to be a trial?' He said if a trial could provide better evidence that was a positive thing, but it was worrying that there seemed to have been a decision not to wait for the NICE guidance.
The DoH was still working on how to implement a statutory obligation on the NHS to fund drugs and treatments recommended to NICE, as HSJ went to press.
Health Technology Board: days are numbered The deputy Scottish health minister has given the clearest indication yet that the days of the Health Technology Board for Scotland, in its present form at least, are numbered.
Malcolm Chisholm confirmed that a report will be published shortly, outlining the way forward for national health bodies and 'how they relate to each other'.He said the fundamental work of HTBS would continue, along with related work by the Drugs Consortium.
At the moment, HTBS's advice can be ignored by each area health board's drugs and therapeutics committee, which advise on new treatments.This was shown in a parliamentary debate last week where it emerged that some health boards were 12 times more likely to prescribe drugs for Alzheimer's disease than others, despite HTBS advice.
It is believed that HTBS will have its functions merged with the Clinical Standards Board for Scotland.