Inspection and Regulation

17.01.19

Patient groups in appraisals of NHS drugs receiving undeclared funds from manufacturers, review finds

Two-thirds of patient groups involved in the appraisal of drugs and treatments for use in the NHS received money from the manufacturer or a competitor that they had not declared, according to new research.

The team behind the review is calling for stronger policy on disclosure and greater transparency from patient organisations and manufacturers to ensure that healthcare decisions are not unduly influenced by industry.

Patient groups are involved in the assessment of new medicines and treatments in the NHS, known as technology appraisal, and are asked to give their views when the National Institute for Health and Care Excellence (NICE) is deciding whether to approve a treatment for NHS use.

The review, carried out by scientists from the London School of Hygiene and Tropical Medicine and published in the British Medical Journal, said whilst patient involvement in decisions is “essential to an accurate and fair assessment” of new technologies, potential bias must be taken into account.

The team assessed 53 patient organisations which contributed to 41 NICE technology appraisals published between 2015 and 2016, and said that whilst some groups were transparent, others refused to help.

They found that 38 out of the 53 patient groups “held specific interests”, which means they received funding from manufacturers or competitors of a technology under appraisal, and were present on 79% of occasions that groups contributed to appraisals.

But the results also showed that NICE’s committees were aware of less than a quarter of these specific interests, and, as disclosure by patient groups is not required under current policy as it is in France, nearly two-thirds of the specific interests go unknown and risk affecting major industry decisions.

Dr Kate Mandeville, lead author from the London School of Hygiene and Tropical Medicine, commented: “NICE needs to urgently strengthen its disclosure policy for patient organisations to reassure the public that drug decisions are not unduly influenced by industry.”

“It is essential that patients can contribute to decisions over which new drugs should be made available on the NHS. Patients’ perspectives give important information on the impact of the condition and lead to better decisions.”

She called NICE a pioneer in involving patients in drug decisions, but found that its disclosure policy does not provide decision makers with enough information on funding received to make a valid assessment of treatments.

NICE said it knew patient groups received funding but “were not aware of the extent of these interests,” adding that it had already started looking into reviewing its policy using the review’s recommendations.

Image credit - SolStock

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