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£80m treatment fund to speed up access to new medicines

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A “genuinely ground-breaking” £80m treatment fund has been launched by Wales’ health secretary, promising speedier access to new medicines.

Vaughan Gething said it would be better than the system in England and Scotland and “more consistent”.

Health boards in Wales will be given an extra £16m a year.

It is intended to ensure new drugs become available within a maximum two months of being approved as cost-effective for use in the NHS.

It follows concerns that health boards have been too slow and inconsistent in finding money for new treatments after they have been given the go-ahead.

England and Scotland have established funds to extend access to new medicines but for specific conditions.

In England, there is as a fund for new cancer drugs while Scotland provides extra money to pay for medicines for patients with rare or end-of-life conditions.

WHAT THE FUND MEANS FOR WALES:

  • Money is available for drugs to treat any condition, provided they have been recommended as cost effective by experts
  • Recommended medicines will be available up to eight weeks earlier and will shorten by a third of the maximum amount of time before health boards have to make a treatment available
  • Health boards will be expected to begin introducing medicines once a decision is made and not wait until the end of an appeal period

The expense of developing new medicines often leads pharmaceutical companies putting high costs on the product which means health trusts struggle to pay for the new drugs.

Cost benefit analysis of new drugs and treatments are made by two organisations: The National Institute of Clinical Excellence (NICE) – which makes recommendations in England and Wales and the All Wales Medicine Strategy Group (AWMSG) – which provides specific advice to the Welsh Government.

The new fund means health boards must make sure new medicines are available within two months of final guidance being published by either body.

Case study: “I’ve been suffering so badly”

Simon Harben from Llantrisant, Rhondda Cynon Taff was diagnosed with progressive multiple sclerosis 20 years ago and over the past year has been trying to access a prescription drug that would help ease his pain.

He said he suffered with fatigue and numbness in his arms and legs which makes it difficult to walk.

“The last six weeks I’ve been suffering so badly with fatigue I just haven’t been able to go to work,” he said.

“I’ve always been active and done a lot of hiking, but now my life consists of getting up and spending most of the day napping on the settee.”

Mr Harben said the drug he has been trying to access was “very useful” for about 50-60% of people with his condition, but his postcode prevents him from being prescribed it.

“People in the Cardiff area are being prescribed it, but because I come under Cwm Taf (health board) my consultant is unable to prescribe it for me.

“It’s very frustrating,” he said.

“Basically if I lived on the other side of the M4, which is about a mile away, I would be on the drug.

“All I want to do is try and be fit enough to be able to attend work and carry on a half normal life.”

Since last April, 55 new medicines have been recommended by the two agencies, treating diseases ranging from rheumatoid arthritis, cancers, epilepsy, to heart disease and HIV.

Mr Gething said: “Our new treatment fund will deliver swift access to innovative new medicines to support people with life-threatening conditions in Wales.

“New medicines and treatments are being discovered, developed and tested on an almost weekly basis, offering the hope of a cure or a better quality of life for people with a range of life-threatening illnesses.”

The fund was a key promise in Labour’s manifesto for last year’s assembly election.

He said it would help remove the time lag and uncertainties around funding for new treatments in the future.

Mr Gething added that the fund would make a “huge difference”, ensuring NHS Wales is in the best possible position to provide the latest approved drugs”.

The pharmaceutical industry also welcomed the move as a “very progressive policy” and a “sea change” in removing hurdles to accessing medicines.

Rick Greville, director of the Association of the British Pharmaceutical Industry Wales (ABPI) said: “There have been big challenges for health boards in terms of their planning and their ability to horizon-scan these medicines.

“I think today will remove some of the obstacles to the financial challenges that health boards found.”

Lynne Hughes, director of the MS Society in Wales, welcomed the concept but said the issue was not just about money but wider support.

“Sativex was approved for Wales in summer of 2014 yet two years on there are people with multiple sclerosis deemed as eligible who are struggling to access this drug.

“But it’s also about ongoing support from MS nurses, neurologists, follow-up appointments and monitoring. It’s not just about funding the drug but funding the proper care and infrastructure around the drugs and that’s what we’d like to see in place from the Welsh Government as well.”

Conservative health spokeswoman Angela Burns AM called the fund a “positive step forward”.

She added: “Historically, too many people have been denied life-saving treatment simply because it is too expensive – this is a moral wrong which the new fund goes some way to redressing.”

The new fund will not be used to pay for treatments that have not been recommended as cost-effective.

Applications for those types of treatments can be made through a separate process known as the Individual Patient Funding Request (IPFR) route – where health-boards make decisions on a case-by-case basis.

In September, Mr Gething confirmed there would be a review of the IPFR process looking at the consistency of decisions across the Welsh NHS and the eligibility criteria for patients applying for medicines.

It followed concerns of that a a postcode lottery existed in accessing drugs through the IPFR route.

The outcome of the review is expected shortly.

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