Working with the life sciences industries to create value / Sir Andrew Dillon, chief executive of the National Institute for Clinical Excellence (NICE)
- 1. Working with the life sciences industries to create value Biocat Barcelona, 24 N B l November 2011 b
- 2. The purpose of NICE • H l th h lth service i Help the health i improve th quality of care the lit f • Increase the rate of adoption of effective and cost effective new technologies by the health system • Work with companies to help them understand what the health system needs and how the additional value that thier products bring to patients is assessed
- 3. Health technologies • Pharmaceuticals Ph ti l • Biotech • Diagnostics Di ti • Medical devices • We want to see products which bring additional diagnostic and th di ti d therapeutic b ti benefit f patients and fit for ti t d which make good use of health system resources
- 4. NICE: defining value Outcomes for patients Impact on Stakeholder health perspectives system resources Scientific and social value judgements
- 5. NICE: NICE cost effectiveness analysis t ff ti l i 1 x Probability of rejection j Rituximab for x Imatinib for follicular lymphoma chronic myeloid leukaemia (blast phase) Trastuzumab for early stage HER-2 positive b iti breast t x cancer 0 16 32 48 64 80 Cost per QALY ($’000)
- 6. Most new health technologies bring additional value Decision D i i Recommendations R d i Yes 276 (63%) 82% of NICE advice is positive Optimised 83 (19%) Only in research 24 (5%) No 55 (13%) Breakdown of all decisions contained in published NICE Technology Appraisals p gy pp 1–236 (January 2000 to October 2011) Note: 6 withdrawn recommendations and 10 non-submissions are not included
- 7. Helping innovators understand value • Early t E l stage scientific advice i tifi d i • Wider definition of value • Transparent and inclusive evaluative processes T t di l i l ti • Clear and detailed guidance • Targeted research questions
- 8. Helping innovators understand value • Early t E l stage scientific advice i tifi d i • Wider definition of value • Transparent and inclusive evaluative processes T t di l i l ti • Clear and detailed guidance • Targeted research questions
- 9. Scientific Advice Programme • I t Interpretation of NICE t h l t ti f technology appraisal methods i l th d guidance • Research design (study population duration population, duration, comparators, endpoint(s), type of study) • Economic evaluation design (e g form of evaluation (e.g. and approaches to benefit measurement; relevant trial(s) for economic evaluation; the use of (QALYs) ( ) ( ) • Methods issues (e.g. selection of instruments / research to derive QALYs; extrapolation of long-term outcomes; planning for indirect comparisons) • Insights from existing appraisals
- 10. Value based pricing • R Recent UK G t Government proposals (to be i t d t l (t b introduced d from 2014) designed to extend the definition of value in UIK drug appraisal and reimbursement decisions decisions. • Increased focus on: – Wider societal benefits – Products which address areas of unmet need or high burden of illness – New products with particularly innovative features • Seen as an evolution of and not a replacement for the PPRS and NICE arrangements
- 11. Conclusion • I Innovators and health systems need t work t t d h lth t d to k together to th t create and deliver value for patients • We need to establish the earliest possible dialogue between companies and agencies that assess new technologies • Health systems – and the agencies that work for them have a responsibility to support innovation and to work p y pp constructively with the companies that deliver it