Funding medicines for people with multiple sclerosis

Providing outcome guarantees may help fund innovative treatment

The establishment of the National Institute for Clinical Excellence (NICE) in 1999 was one of the cornerstones of New Labour's strategy for improving the NHS. Its mission includes giving guidance on how medicines should be prescribed to provide affordable value for money. This should eliminate postcode rationing, whereby some NHS patients are given expensive drugs depending on where they live, while people with similar needs elsewhere are denied the same treatment.

Recommendations from NICE have often levelled up access to pharmaceutical care. But a recent decision by NICE not to support the use of interferon beta in multiple sclerosis has become a focus of critical attention. Patient support groups and pharmaceutical companies argue that this will undesirably lower standards of NHS care. There are also concerns among pharmaceutical companies that where Britain leads in restricting access to new drugs others may follow. The waters have also been muddied by news that Britain's Department of Health is negotiating with manufacturers of interferon beta to find a way of funding the drug for patients with multiple sclerosis on a “sale or return” basis.1

When, last month, NICE published its “final appraisal …