UK's NICE says "No," SMC says "Yes" to new drugs, DoH want doctors to decide

The divergence between decisions on clinical efficacy across different parts of the UK has been highlighted by a series of recommendations by the National Institute for Health and Clinical Excellence (NICE) and the Scottish Medicines Consortium.

The NICE is the UK advisory body which recommends medical treatments in England and Wales under the National Health Service, while the SMC is the equivalent body for Scotland. Recent cases where one advisory group recommends a drug, while the other refuses to propose that NHS patients are provided with it, have tended to show a bias towards the SMC accepting new products and a reluctance to do so by its London-based counterpart.

An example of this is treatment for wet age-related macular degeneration, where the SMC has this month endorsed Novartis' Lucentis (ranibizumab), which was cleared across the European Union in January (Marketletter January 29). Global drug giant Pfizer's Macugen (pegaptanib injection), the main alternative to Lucentis, was cleared by the Scottish authorities late last August. Meanwhile, the NICE, which recently claimed that its new fast-track approval process was improving patient access to oncology products (Marketletter May 21), is due to rule on both drugs in September. Until then, Steve Winyard, a spokesman for the Royal National Institute for the Blind, warned that "wet AMD patients in other parts of the UK face an uphill struggle to get hold of the treatments." Reported by the Daily Telegraph. he said that about 80% of primary care trusts refuse to fund the treatment, which costs about L28,000 ($55,087) in the case of Lucentis.