Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what was the cost of treatment with anti-viral drugs for each hepatitis C patient treated by NHS England in 2016–17.
Answered by Lord O'Shaughnessy
Hepatitis C medicines are subject to commercially confidential pricing agreements so it is not possible to disclose the cost for each patient treated. NHS England spent in excess of £200 million on direct-acting antivirals for hepatitis C in 2016-17.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many hepatitis C patients were treated using the new anti-viral drugs by NHS England in the year 2016–17; and what proportion remain free of the virus post-treatment.
Answered by Lord O'Shaughnessy
Based on data from National Health Service trusts, the NHS treated 9,440 of the planned 10,000 patients with new anti-viral drugs in 2016-17. Data on the proportion that remain virus free is still being analysed; this information should be available by the end of 2017 when the new hepatitis C registry being established by NHS England will be fully operational.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many patients diagnosed with hepatitis C remain to be treated with new anti-viral drugs; and when NHS England expect them all to have received such treatment.
Answered by Lord O'Shaughnessy
An estimated 160,000 people in England are thought to be living with chronic hepatitis C infection. The current number of people diagnosed and yet to access treatment is difficult to state with certainty. National surveys of people who inject drugs suggest that only about half are aware of their hepatitis C infection; this figure has remained relatively stable over the past decade.
NHS England is planning a sustainable roll out of treatment which will complete the treatment of 71,000 individuals between 2015/16 and 2020/21.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many hepatitis C patients NHS England intend to treat using the new anti-viral drugs in 2017–18.
Answered by Lord O'Shaughnessy
Treatment of 12,500 hepatitis C patients is planned in 2017/18.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of whether the procurement exercises for hepatitis C medicines have resulted in lower costs to the NHS of hepatitis C medicines than those costs which informed the guidance set out in technology appraisals 363, 364 and 365 published by the National Institute for Health and Care Excellence.
Answered by Lord Prior of Brampton
The Department’s Commercial Medicines Unit manages, on behalf of English National Health Service secondary care, a tender strategy which establishes framework agreements for hepatitis C medicines under which prices are set. This programme commenced in August 2015 and has resulted in ongoing price reductions.
In developing its recommendations on the use of daclatasvir (TA364) and ombitasvir–paritaprevir–ritonavir with or without dasabuvir (TA365) for the treatment of chronic hepatitis C, the National Institute for Health and Care Excellence (NICE) took into account the prices that had been agreed by the Commercial Medicines Unit at the time NICE’s guidance was being developed as the companies provided this information as part their evidence submissions to NICE. For the appraisal of ledipasvir-sofosbuvir for chronic hepatitis C (TA363), the company did not submit the equivalent information as evidence for consideration in the appraisal and NICE’s recommendations are based on the published list price for the drug. As a result of subsequent procurement exercises, these drugs may be available to the NHS at lower prices than when NICE developed its technology appraisal guidance.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether savings realised through the procurement exercises for hepatitis C medicines were taken into account by the National Institute for Health and Care Excellence in its cost modelling in technology appraisals 363, 364 and 365.
Answered by Lord Prior of Brampton
The Department’s Commercial Medicines Unit manages, on behalf of English National Health Service secondary care, a tender strategy which establishes framework agreements for hepatitis C medicines under which prices are set. This programme commenced in August 2015 and has resulted in ongoing price reductions.
In developing its recommendations on the use of daclatasvir (TA364) and ombitasvir–paritaprevir–ritonavir with or without dasabuvir (TA365) for the treatment of chronic hepatitis C, the National Institute for Health and Care Excellence (NICE) took into account the prices that had been agreed by the Commercial Medicines Unit at the time NICE’s guidance was being developed as the companies provided this information as part their evidence submissions to NICE. For the appraisal of ledipasvir-sofosbuvir for chronic hepatitis C (TA363), the company did not submit the equivalent information as evidence for consideration in the appraisal and NICE’s recommendations are based on the published list price for the drug. As a result of subsequent procurement exercises, these drugs may be available to the NHS at lower prices than when NICE developed its technology appraisal guidance.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether procurement exercises have taken place to reduce the prices paid by the NHS for new hepatitis C medicines.
Answered by Lord Prior of Brampton
The Department’s Commercial Medicines Unit manages, on behalf of English National Health Service secondary care, a tender strategy which establishes framework agreements for hepatitis C medicines under which prices are set. This programme commenced in August 2015 and has resulted in ongoing price reductions.
In developing its recommendations on the use of daclatasvir (TA364) and ombitasvir–paritaprevir–ritonavir with or without dasabuvir (TA365) for the treatment of chronic hepatitis C, the National Institute for Health and Care Excellence (NICE) took into account the prices that had been agreed by the Commercial Medicines Unit at the time NICE’s guidance was being developed as the companies provided this information as part their evidence submissions to NICE. For the appraisal of ledipasvir-sofosbuvir for chronic hepatitis C (TA363), the company did not submit the equivalent information as evidence for consideration in the appraisal and NICE’s recommendations are based on the published list price for the drug. As a result of subsequent procurement exercises, these drugs may be available to the NHS at lower prices than when NICE developed its technology appraisal guidance.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government on what basis, if any, the NHS Mandate requires that investment in NICE-recommended treatments for hepatitis C be limited to avoid disinvestment in other health services.
Answered by Lord Prior of Brampton
The NHS Mandate requires healthcare expenditure to be limited to the resources made available by the government. The range of potential treatments which could improve patients health exceeds the funding made available to the National Health Service, therefore increased investment in one area has an opportunity cost on the ability to invest in other areas. NHS England is investing in the rollout of Hepatitis C treatment in full accordance with National Institute of Health and Care Excellence guidance, with an expected doubling of the number of patients benefiting from new treatment to 10,000s in the coming year.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the breakdown of the patient treatment capacity for each Operational Delivery Network for hepatitis C, broken down by hub and spoke.
Answered by Lord Prior of Brampton
NHS England does not hold this information. NHS England is not the responsible commissioner for all services in which the treatment of people with hepatitis is undertaken.
Asked by: Lord Mancroft (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the breakdown of run rates assigned to each Operational Delivery Network for hepatitis C, broken down by hub and spoke.
Answered by Lord Prior of Brampton
Operational Delivery Networks (ODNs) lead organisations in collaboration with the local NHS England commissioning team are responsible for approving the organisations involved in the ODN. The ODN lead provider is responsible for working with its partners in determining how the patient numbers will be managed across its network. NHS England does not hold this information.