The NHS is limiting patient care by reducing access to medicines in order to achieve short-term cost control targets, the ABPI has said.

At its annual conference, the industry association emphasised that France, Spain and Germany spend three times as much per patient on new medicines as the UK.

While it focused on medicines, the ABPI statement echoed comments from the NHS Confederation on the way that ‘salami slicing’ of healthcare is being used as a short-term financial solution.

Both organisations are calling for service redesign to shift healthcare from the hospital to the community, rather than further cutbacks to existing services.

In particular, the ABPI noted, denying patients access to new medicines on grounds of cost is holding back the treatment of long-term conditions within the community, while giving hospitals more work.

Spending on new medicines is set to rise by only 1.3% by 2015 – half the projected increase in total NHS spend, and far below the rate of inflation.

The UK spends 74p per person per day on medicines, compared to over £1 in Spain, Germany and France. It spends only 7p per person per day on new medicines, compared to over 20p per day in those countries.

Stephen Whitehead, Chief Executive of the ABPI, said: “Our healthcare system needs to focus much more on caring for patients in their own homes and much less on treatment in expensive hospitals. Investing in new, innovative medicines will be absolutely key to this.

“By 2015, the new medicines which are being launched now will make up just 2.5% of the entire medicines budget, and yet it is these treatments which are able to transform the way many diseases are treated.”

A limited ‘experimental’ version of the Government’s Innovation Scorecard points to variation and low overall levels in patients’ access to new NICE-approved medicines across England.

The spreadsheet and report published by the Health and Social Care Information Centre summarise the existing data on the availability of 76 medicines and 6 medical technologies recommended by NICE through NHS organisations.

While the initial ‘scorecard’ cannot be used to assess the performance of individual organisations, it will stimulate discussion on how to develop a fuller and more accurate version.

The goal of the Innovation Scorecard is to support the uptake of innovative therapies by the NHS, in line with the Government’s ‘Innovation, Health and Wealth’ strategy.

More information is needed to address the causes of the variation in availability of these treatments, since patient demographics and local purchasing arrangements may influence the data.

The report includes: estimates of actual and expected use of medicines; volumes of medicines used in primary care (daily dose per 100,000 of CCG population); and volumes of medicines used in secondary care (mg of drug purchased by hospital trust per 100,000 bed days).

The ABPI has expressed concern that the initial ‘scorecard’ not only reveals widespread variation but also shows the uptake of new medicines to be generally well below the expected level.

Stephen Whitehead, ABPI Chief Executive, commented: “This first Scorecard is less detailed than ABPI hoped for and we envisage future scorecards offering more details on how the NHS is complying with NICE guidance. But we welcome its publication as a first step on a transparency journey in the new NHS.

“I believe the Government understands the challenges, but it must act quickly and decisively to drive the adoption and diffusion of the newest and most innovative medicines across England.”

The introduction of value-based pricing (VBP) will not solve the issues around the access to new medicines in the UK, a new report says.

Current Stakeholder Perspectives on Value-Based Pricing, a report from charity Myeloma UK, notes 19 recommendations the Government should consider to improve VBP.

Eric Low, Chief Executive of Myeloma UK, said the recommendations “ensure any new system of VBP is the best it can be”.

The report questioned opinion leaders and experts from academia, the NHS, patient groups and the pharmaceutical industry to generate the recommendations.

They focus on price-setting, threshold setting, uncertainty and medicines uptake at a local level. Recommendations include:

• The Government conducting research to establish the relationship between pharmaceutical pricing and the location of research and clinical trial centres
• Cost-effectiveness thresholds under VBP should be set by a new, independent advisory body
• VBP should involve greater coordination between NICE, pharma and other stakeholders to ensure there is appropriate evidence collection about a new medicine prior to its launch
• Determining the value-based price of a new medicine should be a transparent process, but the price agreed could remain confidential to protect the UK as a reference-pricing market.

The Department of Health revealed plans back in December 2010 to replace the existing Pharmaceutical Price Regulation Scheme with a value-based approach from 1 January 2014.