New medicines review published

6th May 2013

An independent review of the current systems for making new medicines available across NHS Scotland has been published recently.

The review considered every aspect of the introduction of new medicines from national advice to local decision-making to establish whether any improvements can be made. The recommendations include:

More public involvement in the assessment of new medicines and local Health Board consideration of individual requests for drugs not routinely available;
Increased flexibility to consider new evidence on cost or effectiveness of a drug while it is being assessed;
National data on decisions about individual requests for drugs not recommended for routine use should be published annually to be more open and transparent;
Increased scrutiny of health board decisions about requests for drugs not recommended for routine use to assess consistency of processes.
The recommendations of the review, alongside any recommendations from the forthcoming Health and Sport Committee report into new medicines, will be open to a brief consultation this summer.

An interim recommendation from the review - a £21 million fund to cover the cost of medicines for patients with very rare conditions - has already been introduced.

Health Secretary Alex Neil said:

"I am proud that Scotland is among the fastest and most efficient medicine review processes anywhere in the world.

"However, we can’t overlook the concerns raised by clinicians, charities and patients about access to medicines.

"That is why I commissioned this independent review, which provides some key recommendations on how to improve access arrangements for new medicines in Scotland to make them better than ever before.

"New medicines are a complicated issue and we have to make sure that we do this properly. Our proposed response to the review recommendations, as well as any recommendations from the Parliamentary Committee on Health and Sport, will be subject to consultation.

"Many of the recommendations focus around making sure the system is as open and transparent as possible and I want everyone to have their say on how we make sure that the Scotland has the best system possible."

The Scottish Medicines Consortium (SMC) appraises all newly licensed medicines and provides advice to NHS Boards on their clinical and cost-effectiveness.

Currently, if a medicine is accepted for use by the SMC then individual health boards set the criteria for prescribing it, taking account of other medicines available to treat the condition in question. If the medicine is not recommended then Health Boards do not make it routinely available. However, clinicians may be able to prescribe medicines that are not accepted for routine use by the SMC for individual patients in certain clinical circumstances by special request through Individual Patient Treatment Requests.

Independent expert, Professor Philip Routledge reviewed current new medicines assessment processes of the Scottish Medicines Consortium (SMC) against those of similar organisations elsewhere, to see if there are any areas of good practice that Scotland could learn from.

The Chief Pharmaceutical Officer Professor Bill Scott commissioned Professor Charles Swainson to review how SMC decisions are implemented by NHS Boards Drug and Therapeutic Committees to ensure there is a consistent and effective approach, including individual patient treatment requests to establish whether any further improvements can be made.

The focus of this review is to ensure there is a consistent and effective approach to prescribing policies for new medicines across the country.