NHS England tried to sabotage the release of hepatitis C drugs because it couldn't afford them, it has been claimed.
The claims have been made by the British Medical Journal, following a joint investigation with the Universities of Bath and Cambridge. The allegations reignite debate surrounding the impact of funding cuts to the NHS and the soaring costs of drugs under some pharmaceutical companies.
It is alleged that NHS England failed to properly plan for expensive new hepatitis C drugs which were introduced in 2014, meaning that it did not have enough funds to introduce them once they were approved by the regulatory body, the National Institute for Health and Care Excellence (Nice).
Under current procedures, drugs approved by Nice typically become widely available to NHS patients after a statutory period of 90 days. However, the BMJ claims: “In an apparent panic over high prices and affordability, NHS England deployed many delaying tactics to block timely access to the hepatitis C drugs.”
The organisation allegedly requested an extension to implement the drugs, questioned the evidence of the drug without justification and exaggerated how much it would cost, in order to stall the drugs becoming available until the following financial year when it would have more funding.
Concerns have been raised that this meant sufferers of hepatitis were thereby denied timely access to essential medicines.
Andrew Ustianowski, one of the members of NHS England’s six-person clinical advisory group, told the BMJ he resigned in protest at attempts to delay access to the treatments. He said: “I pulled out of the advisory group on principle, because of everything that was going on. I didn’t want to be associated with what was happening.
“They said the advisory group was agreeing that the treatment centres around the country hadn’t got the capacity and that’s wrong – of course there’s capacity to treat more people. The responses NHS England were giving were to try to delay the process, either to give it more time to try to work out what to do, or if you’re cynical, to push some of the costs into the next financial year.”
“I just got to the stage where I didn’t want to be associated with delaying patients getting access to the treatments,” he said.
Dr Ustianowski added that he was concerned hepatitis may have been chosen as a disease to delay as most people with hepatitis C are former intravenous drug users and thereby stigmatised and marginalised in society, making them an easier target. He said: “If you are going to choose a fight then choosing this battlefield is quite a sensible thing to do – a marginalised population, very high-cost drugs.”
Fellow hepatitis advisory group member Steve Ryder also claimed NHS England had acted to delay the drugs, despite it not being in patients’ best interests. He said: “[NHS England’s] position was that the hepatitis C drugs were unaffordable and the figure they quoted in the Nice submission was something like £2bn, which was clearly fantasy.
“The assumption to come up with that figure was that you had no discounts on any of the drugs at all and that every single person with hepatitis C in England would come forward that year for treatment, so it was a completely ridiculous standpoint to take.”
A spokesperson for NHS England told The Independent that the organisation strongly denies the allegations, which it has labelled “inaccurate and naïve”.
The spokesperson said: “It is utterly naïve to pretend that the NHS could instead somehow have 'magicked up' several billion pounds in one year, for this one condition, without that meaning damaging cuts in other critical services such as mental health, cancer or primary care. That’s not a failure of planning; that’s just the reality of the financial circumstances facing us. What’s more, the House of Commons Public Accounts Committee rightly pointed out that under circumstances such as this, the NHS should take account of affordability.
“Actually, what the NHS has done is invest an extra £200m in Hep C treatments last year and again this year, making it the single biggest new treatment investment in years. With that we've treated high-risk patients, and like many other countries are now working through the backlog of non-urgent patients.
“As prices come down due to more competition between drug companies, in future years we'll be able to expand Hep C treatments even further within the funding available, and the industry is now engaging in discussions with us about how best to do this.”
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