Delays to the introduction of groundbreaking, cost effective hepatitis C drugs have occurred because of ‘budget constraint’, NHS England’s specialised commissioning director has indicated.

Speaking at a conference last week, Richard Jeavons said the arrival of innovative new treatments for the condition presented a “unique set of circumstances” that had tested traditional drug approval processes.

Richard Jeavons

Richard Jeavons said the new hepatitis C drugs presented ‘a unique set of circumstances’

In January, the National Institute for Health and Care Excellence announced it had agreed to a request by NHS England to extend by three months the timetable for implementing NICE’s recommendations on the drug Sofosbuvir. The new deadline was set for the end of this month.

Charities claimed NHS England had requested the delay to control costs, but the arm’s length body said it needed more time to set up a network to deliver the treatment.

A commissioning policy for cirrhosis, which was supposed to be in place from April, was only delivered last month. A number of charities also wrote to the health secretary claiming NHS England was holding up the NICE appraisals of other treatments on affordability grounds.

Speaking at the Specialised Healthcare Alliance conference, Mr Jeavons indicated cost had been an obstacle to rolling out new hepatitis C drugs.

Responding to a question on the drugs, he said: “Nobody at NHS England wants to stop the introduction of high quality, cost effective treatments.

“But on the other hand budget constraint is budget constraint is budget constraint.”

In their letter to the health secretary last month, the charities’ said limiting the availability of new treatments on the basis of budget impact rather than clinical and cost effectiveness could set a “dangerous new precedent”.

However, Mr Jeavons said the arrival of new hepatitis C drugs was “quite a unique set of circumstances” and the situation should not be viewed as “typical”.

“There has never before been a situation in which in a relatively short period of time, the opportunity to expend relatively huge amounts of money quite quickly, is put before us,” he said.

He said when NICE was founded it had conducted “scenario testing”, including looking at “if treatments came along that were so cost effective and so overall expensive to the NHS, what would we do?”

“About 15 years ago when they were setting NICE up they actually imagined themselves where we are today with these fantastic opportunities with hepatitis C.

“You might want to go and ask [NICE chief executive] Andrew Dillon what the answer was in the scenario testing they did, because it was a dilemma then and it’s a dilemma now.”