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Personal Views Personal views

The price isn't right

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7309.407 (Published 18 August 2001) Cite this as: BMJ 2001;323:407

Rapid Response:

UK price of beta interferon for MS

Dear Sir

It was impossible to be unmoved by Dr Andrew Dyson’s excellent
account of coming to terms with his wife’s diagnosis of multiple sclerosis
(MS) and the difficulties of obtaining access under the NHS to one of the
three beta interferon products licensed for this indication1.

Unfortunately, this is an all-too-frequent story in the UK, where only 2%
of people with MS are receiving a beta interferon, compared to around 12
to 15% in most other European countries and an even higher percentage in
the US. As I work for a company which manufactures a beta interferon
product, albeit different to the one which was the subject of Dr Dyson’s
Personal View, I must declare a vested interest. Nevertheless, I would
like to respond on behalf of the pharmaceutical industry regarding the
issue of differential pricing between countries.

When our beta interferon (Betaferon, interferon beta-1b)
was launched in the UK and Europe (1995), worldwide prices were
comparable. Huge currency differences have developed subsequently across
Europe, with the pound being strengthened by a third to the Deutsche Mark
since 1995. Additionally, it is always difficult to compare prices across
different countries because of differences in healthcare systems which may
increase over time.

In the UK, prices of branded pharmaceuticals are controlled by the
government; different policies operate in different countries. Schering
Health Care Ltd prices our beta interferon in accordance with the
Pharmaceutical Pricing Regulation Scheme (PPRS), negotiated between the
Department of Health and the Association of British Pharmaceutical
Industries (ABPI). The scheme controls the cost of medicines to the NHS,
and does not guarantee that the manufacturer makes any profit on a
particular product. This differs from other European countries where
reimbursement can vary between categories of treatments. In some
instances the treatment is reimbursed 100% and other treatments can be
reimbursed at 65%, 35% or 0%. In Germany there are insurance schemes
provided by the government which will fully reimburse treatments such as
beta interferon and in Italy the price of the product is agreed in
accordance to the number of units sold.

The pharmaceutical industry also funds additional services in the UK
that meet the special needs of our resource-starved health system. There
are fewer than one fifth the neurologists per head of population in the UK
than in most other developed countries2. For example, specialist MS
nurses, supported wholly or in part by industry, work within the NHS and
make a huge contribution to the care of people with MS in the UK. This
includes the vast majority who do not receive any beta interferon or other
disease-modifying treatment.

As part of our compliance with the PPRS, the UK price of our beta
interferon has had two modulations this year. The current cost of
Betaferon in the UK is £7,263.97 per patient per annum, not so
very different to the price Dr Dyson is paying for beta interferon from
Australia.

Yours faithfully

Dr Jacqueline C Napier MRCP

Associate Medical Director, Schering Health Care Ltd,Burgess Hill, W
Sussex RH15 9NE

E-mail: jnapier@schering.co.uk

References:

1. Dyson A The price isn’t right BMJ 2001; 323:407

2. Kmietowicz Z United Kingdom needs to double the number of neurologists
BMJ 2001; 322:1508

Competing interests: No competing interests

31 August 2001
Jacqueline Napier
Associate Medical Director
Schering Health Care Ltd