It is difficult to tell from this story (below) whether there is in fact some concrete compulsion to make available Nice-recommended drugs, or whether the line being pursued is a straightforward 'name and shame' one. It seems, in spite of the rhetoric, to be the latter.
The focus here is on hospitals (although it's not clear it's just that - indirectly on purchasers perhaps), but it's hard to see how a hospital can act unilaterally to introduce a new more expensive treatment/technology and not make a loss without the agreement of the purchaser to pay above and beyond the existing tariff - at least until tariffs are reviewed.
Maybe this is how the government intends to 'not interfere' in purchasing decisions. But I'm wondering if it will be particularly effective.
Is there any comparable use of scorecard-type mechanisms for new drugs/technologies provision in any part of the US health system? If so, are there any positive/negative lessons to be drawn? And would US experience even be relevant to the phenomenom of poor areas vs middle class areas (as opposed to United vs Aetna) we have here?
Tom
http://www.guardian.co.uk/society/2012/aug/28/scorecards-nhs-inequality-over-drugs
Scorecards' to end inequality over NHS drugs
Measure aims to tackle regional disparity of medicines and treatments
Press Association
The Guardian, Tuesday 28 August 2012
The new rules will allow the public to compare the speed at which NHS hospitals roll out new care methods and drugs.
NHS "scorecards" are to be introduced to tackle the regional disparity of medicines and treatments.
Under the scheme, expected to be launched before autumn, hospitals will have "no excuse not to provide the latest approved drugs and treatments", the Department of Health said.
Hospitals that delay acting on guidance from the health watchdog, the National Institute for Health and Clinical Excellence (Nice), will be forced to explain holdups to patients, it said.
The new rules will allow the public to compare the speed at which NHS hospitals roll out new care methods and drugs.
Currently some primary care trusts delay offering new drugs as recommended by Nice, while other areas use them on patients straight away.
Under the scheme, NHS organisations will be automatically added on to publicly available lists of what drugs are available in local areas.
It is hoped the rules will create a level playing field for treatments such as IVF, for which patients living in different regions have had varying levels of opportunity for the treatment.
Last year, a report found more than 70% of NHS trusts ignored Nice guidance to offer infertile couples three chances at IVF, and some stopped funding treatment.
Some of Nice's most recent guidance, recommending an extended time to administer a clot-busting drug to treat stroke patients, for example, will soon have to be taken on by all hospitals.
The Department of Health said the uptake of new drugs and treatments will also be made quicker by setting up a new group to help local NHS organisations implement the guidelines.
The health minister, Paul Burstow, said: "Patients have a right to drugs and treatments that have been approved by Nice. This new regime will be a catalyst for change – we are determined to eradicate variation and drive up standards for everyone.
"NHS organisations must make sure the latest Nice-approved treatments are available in their area, and if they are not, then they will now be responsible for explaining why not.
"Being transparent with data like this is the hallmark of a 21st century NHS. It is a fundamental tool to help healthcare professionals improve patient care."
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