Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether policies to improve patient access to combination therapies will be considered by his Department in upcoming negotiations for the 2024 Voluntary Scheme for Branded Medicines Pricing and Access.
Answered by Will Quince
The Department is considering how a successor to the voluntary scheme for branded medicines pricing and access should operate from 2024 onwards and will work with industry to agree a mutually beneficial successor that that supports better patient outcomes, ensuring the sustainability of National Health Service spend on branded medicines and enables a strong United Kingdom life sciences industry.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many commercial agreements NHS England has agreed with manufacturers of medicines that allow, support or result in non-uniform pricing by medicine.
Answered by Will Quince
Since 2020 NHS England has agreed 24 commercial agreements that have resulted in non-uniform pricing by medicine, via either the Cancer Drugs Fund or through bespoke commercial deals to support routine commissioning.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of the impact of the NHS continuing to adopt uniform pricing by medicine on patient access to innovative medicines.
Answered by Will Quince
No assessment has been made. NHS England set out their commercial approach to new medicines in the Commercial Framework published in February 2021. The framework sets out, in line with commitments made under the Voluntary scheme for branded medicines pricing and access (VPAS), that the National Health Service can reach complex confidential commercial arrangements with companies that bring new medicines to the market which offer greater levels of health gain relative to cost. The commercial framework allows the flexibility to create different commercial approaches where the importance of the medicine warrants it.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will work with the National Institute of Health and Care Excellence to establish or adapt frameworks which support combination therapies to be assessed and accessed more readily in the UK, as part of NICE's iterative approach.
Answered by Will Quince
The Department wants patients to benefit from access to effective new treatments at a price that represents value and is fair to all parties. The National Institute for Health and Care Excellence (NICE) has been able to recommend over 95% of the combination therapies on which it published technology appraisal guidance between 2017 and 2022. NICE is developing a modular approach to its methods and process updates and potential topics will be considered by NICE taking into account all relevant factors.
NHS England’s Commercial Framework for New Medicines recognises that realising the full potential health benefits from combination drug therapies can be challenging given the requirement for commercial confidentiality and the need to maintain competition.
Alongside NICE, NHS England has been supporting the Association of the British Pharmaceutical Industry (ABPI) efforts to find solutions to enable companies to engage with one another where health-improving combination therapies face challenges coming to market.
In the United Kingdom, the Competition and Markets Authority represents the sole competent authority, and the commercial aspects of bringing combination therapies to the market must be compliant with relevant legislation.
There are currently no plans to establish a task and finish group.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to establish an independently-led task and finish group to consult on and suggest innovative solutions for overcoming pricing, cost effectiveness and legal challenges around patient access to combination therapy treatments in oncology.
Answered by Will Quince
The Department wants patients to benefit from access to effective new treatments at a price that represents value and is fair to all parties. The National Institute for Health and Care Excellence (NICE) has been able to recommend over 95% of the combination therapies on which it published technology appraisal guidance between 2017 and 2022. NICE is developing a modular approach to its methods and process updates and potential topics will be considered by NICE taking into account all relevant factors.
NHS England’s Commercial Framework for New Medicines recognises that realising the full potential health benefits from combination drug therapies can be challenging given the requirement for commercial confidentiality and the need to maintain competition.
Alongside NICE, NHS England has been supporting the Association of the British Pharmaceutical Industry (ABPI) efforts to find solutions to enable companies to engage with one another where health-improving combination therapies face challenges coming to market.
In the United Kingdom, the Competition and Markets Authority represents the sole competent authority, and the commercial aspects of bringing combination therapies to the market must be compliant with relevant legislation.
There are currently no plans to establish a task and finish group.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the implications for his policies of concerns raised by the British Society for Rheumatology with the National Homecare Medicines Committee, Care Quality Commission and General Pharmaceutical Council on the safety and performance of homecare medicines services across England.
Answered by Will Quince
The Department is aware of the British Society for Rheumatology’s (BSR) concerns. Providers of Homecare Medicine services to National Health Service patients do so under framework agreements which may be held at national with NHS England and regional at NHS procurement hubs or local at hospital trust level. This requires a high degree of centralised co-ordination for which the National Homecare Medicines Committee (NHMC) supports and advises the NHS on matters relating to homecare medicines services. The committee liaises with homecare providers through their trade association the National Clinical Homecare Association (NCHA) to support and co-ordinate development of the homecare market and discuss any system wide issues.
When the Key Performance Indicators (KPIs) indicate that the services levels of a provider on a national NHS England framework or NHS regional framework or contract are not to the standard expected, the NHMC which is managed by and includes representation from NHS England enacts an escalation process which involves meetings with individual providers to discuss safety and performance issues. If necessary, the regulators the Care Quality Commission (CQC) and the General Pharmaceutical Council (GPC) are also informed.
The NCHA and NHMC have met with the British Society for Rheumatology to discuss their concerns. Proposals are currently being discussed between the parties to establish a formal, ongoing dialogue which may also include representation from other medical specialties.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has had discussions with relevant stakeholders on trends in the number of (a) nurse and (b) pharmaceutical staff vacancies within the (i) quality assurance and (ii) governance disclipines of homecare medicines services.
Answered by Will Quince
NHS England’s Commercial Medicines Unit, which manages the national framework agreements for the provision of homecare medicines services, holds regular engagement meetings with providers on the framework and when appropriate will discuss recruitment and retention of staff. The National Homecare Medicines Committee also holds discussions regarding recruitment, retention and vacancies during engagement meetings with providers when appropriate to do so.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether it is his policy to work with (a) patient groups, (b) industry stakeholders and (c) other relevant parties on finding solutions to the challenges of patient access to combination therapy treatments, including (i) a lack of framework for multi-indication pricing, (ii) rigid cost-effectiveness frameworks and (iii) legal barriers.
Answered by Will Quince
The Department wants patients to benefit from access to effective new treatments at a price that represents value and is fair to all parties. The National Institute for Health and Care Excellence (NICE) has been able to recommend over 95% of the combination therapies on which it published technology appraisal guidance between 2017 and 2022. NICE is developing a modular approach to its methods and process updates and potential topics will be considered by NICE taking into account all relevant factors.
NHS England’s Commercial Framework for New Medicines recognises that realising the full potential health benefits from combination drug therapies can be challenging given the requirement for commercial confidentiality and the need to maintain competition.
Alongside NICE, NHS England has been supporting the Association of the British Pharmaceutical Industry (ABPI) efforts to find solutions to enable companies to engage with one another where health-improving combination therapies face challenges coming to market.
In the United Kingdom, the Competition and Markets Authority represents the sole competent authority, and the commercial aspects of bringing combination therapies to the market must be compliant with relevant legislation.
There are currently no plans to establish a task and finish group.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what percentage of cancer therapies assessed by the National Institute of Health and Care Excellence (NICE) have been for combination therapies rather than monotherapies in each year since 2017; and what percentage of terminated NICE appraisals for cancer therapies have been for combination therapies rather than monotherapies in each year since 2017.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Between 1 January 2017 and 31 December 2022, 27% of cancer appraisal recommendations made by the National Institute for Health and Care Excellence related to combination therapies and 38% of terminated cancer drug appraisals related to combination therapies.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when his Department will publish a specification for an electronic prescribing system for homecare medicines services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Homecare Medicines Committee’s (NHMC) standardisation programme includes an NHS Digital strategy project. Within the NHMC there is a digital sub-group working closely with NHS Digital on the output-based specification for e-prescribing for homecare medicines services to use an Electronic Prescribing System. This work is at an advanced stage in preparation for consultation with NHMC during 2023.