Freemantle N
Medicines Evaluation Group, Centre for Health Economics, University of York, Heslington, UK.
Health Policy. 1999 Mar;46(3):255-65. doi: 10.1016/s0168-8510(98)00060-8.
Reform of the existing mechanisms that influence pricing for pharmaceuticals in the UK NHS is overdue. Currently, the prescribing pricing policy favours the needs of industry over those of the NHS and of individual patients. In a recent consultation document, the UK Government indicated an emerging policy that will provide for the assessment of the effectiveness and cost effectiveness of important pharmaceuticals in the NHS. In developing and implementing this policy, much can be learnt from the situation in Australia, where pricing of drugs is related directly to an assessment of their value for money in specific patient groups. In fact, the differing circumstances between the UK and Australia suggest that the progress achieved by the Australians may be supplemented by further reform to encourage a more rational relationship between the NHS and the pharmaceutical industry. Australia has led the world in demonstrating that a modest form of assessment of 'value for money' may be incorporated practically in the process of licensing and reimbursing new drugs. It is important that this finding is built upon in the UK NHS for the benefit of patients and for society as a whole. It is not clear that the current proposals for reform from the UK Department of Health go far enough to achieve the required changes in drug licensing and regulation.
英国国民医疗服务体系（NHS）中影响药品定价的现有机制改革早就该进行了。目前，处方定价政策更偏向制药行业的需求，而非NHS和患者个人的需求。在最近的一份咨询文件中，英国政府表明了一项新出现的政策，该政策将对NHS中重要药品的有效性和成本效益进行评估。在制定和实施这项政策时，可以从澳大利亚的情况中学到很多东西，在澳大利亚，药品定价直接与对特定患者群体中药物性价比的评估相关。事实上，英国和澳大利亚的不同情况表明，澳大利亚所取得的进展可能需要进一步改革来补充，以鼓励NHS与制药行业之间建立更合理的关系。澳大利亚在证明适度的“性价比”评估形式可以切实纳入新药许可和报销过程方面引领了世界。重要的是，英国NHS应在此基础上继续推进，以造福患者和整个社会。目前英国卫生部提出的改革提议是否足以实现药品许可和监管方面所需的变革尚不清楚。
