Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the NICE methods and process review, what steps he is taking to tackle the policy and system barriers NICE has identified as preventing the implementation of the discount rate.

The National Institute for Health and Care Excellence (NICE) is an independent body and is currently reviewing the methods and processes it uses in its health technology assessments, including considering changes to the discount rate applied to costs and benefits.

NICE has recently consulted publicly on a set of proposals for changes to its methods and processes and is considering the comments received. NICE’s consultation stated that there is an evidence-based case for changing the discount rate to 1.5%. However, it acknowledged the wider policy and fiscal implications and proposed to maintain the existing rate while further data is collected on the likely effects of a change. NICE also proposed to maintain a non-reference case discount rate of 1.5% for use in exceptional circumstances.

The Department supports NICE’s proposal, which is in line with the expectations for the review as set out in the Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) agreed with industry. The VPAS has driven significant improvements in patient access to clinically and cost-effective medicines, whilst ensuring sustainable and predictable spend growth for the National Health Service and industry. Aided by the new commercial flexibilities provided by VPAS and the NHS Commercial Framework, NICE now recommends the vast majority of new medicines it appraises, with 100% recommended in 2020/21.