Does the UK National Health Service need a fourth hurdle for pharmaceutical reimbursement to encourage the more efficient prescribing of pharmaceuticals?

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.