Accelerated Access Review

Daniel Zeichner Excerpts

Tuesday 13th December 2016 Westminster Hall

[Daniel Zeichner (Cambridge) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Alan. I congratulate my hon. Friend the Member for Dudley North (Ian Austin) on leading this important debate. We have long needed to address the fact that the UK is trailing behind on patient access to new medicine. A.A. Gill who, just three days ago, sadly died of cancer, wrote:

“The NHS represents everything we think is best about us.”

But in his final column, he revealed that he was denied immunotherapy that might have helped him to live longer. He said that NICE,

“the quango that acts as the quartermaster for the health service, won’t pay.”

His experiences are striking, but they are a symptom that is all too common of a system that is struggling to cope. When Labour established NICE it soon became a world leader in approaching the profound and challenging question of how to allocate scarce resources fairly. Although the question remains the same, the times have changed and the pace of innovation has increased, as has the cost.

We were all pleased when the Government’s long-awaited and much-delayed accelerated access review was finally published. Simply put, we need innovative new drugs to reach patients quickly at a price that the NHS can afford, but it is not clear that the accelerated access review has solved the conundrum. There are already signs, since publication, that yet more problems are emerging. NHS England’s sudden and unexpected consultation on the QALY—quality-adjusted life years—threshold for highly specialised technologies risks running counter to the spirit of the AAR and introducing yet another gatekeeper.

The AAR recommends a fully funded early access to medicines scheme, but we need a positive response from both the Government and NHS England because the danger is that, with other countries having funded early access companies, we risk seeing clinical development work moving away from the UK.

As we have heard, the Cystic Fibrosis Trust has suggested that the AAR made several recommendations that could enable access to drugs such as Orkambi through flexible pricing arrangements and the gathering of real-world data to prove the drug’s effectiveness. Does the Minister agree that those recommendations will make a difference to people affected by cystic fibrosis? If so, will he commit to implementing the recommendations?

Other hon. Members have told us of real-world examples, and I will quote my constituent Julian Wheel:

“My youngest daughter, a local Cambridge primary school teacher for over 15 years, recently had a new daughter, diagnosed with cystic fibrosis. It imposes major changes on her and her partner’s lives in caring for her—time, difficult nutritional choices and the fear of recurrent infection, not to mention the additional and regular workloads imposed on the NHS staff at Addenbrooke’s, the local GP practice in Harston and healthcare visitors.”

He says that their family receive terrific support from the cystic fibrosis clinic and local surgery practice, but this new drug could relieve the suffering and improve their quality of life. He says it could offer “real hope.”

New drugs are expensive, but incentivising innovation should be a priority. The Government must ensure there are effective mechanisms that can help to address the affordability challenges that new treatments are likely to present. A balance will need to be struck between setting a price that rewards and incentivises innovative research and setting a price that is also affordable to the NHS. Will the Minister establish a strategic commercial unit in NHS England to consider flexible pricing models?

Recommendations such as a fully funded early access to medicines scheme could make real inroads, but of course that depends on the Government supporting their implementation. The BioIndustry Association points out that innovation is impaired because the current early access to medicines scheme is not funded, and the lack of funding poses a barrier to many small biotech companies engaging with the scheme.

Across the board, organisations have called for a strong response from the Government to the accelerated access review. I am not sure we yet have that. Will we have one today?