Evaluation of Pharmaceutical Innovation

Conclusions

Reforms to the National Health Service (NHS) in the United Kingdom, consequent upon the NHS and Community Care Act (1990), bring about a structure in which the imperative to make explicit choices among service options cannot be avoided. In particular, establishment of contracts between purchasing health authorities and provider hospitals presents a challenge to both parties to maximise the health gains derived from the limited healthcare resources available. The reforms also provide an opportunity for the pharmaceutical industry to collaborate in establishing a decision-making framework that would ensure that the limited resources available to fund new pharmaceutical innovation are targeted at products that provide the greatest marginal increases in patient welfare. Such a decision-making framework would benefit the NHS (by optimising use of scarce resources) and the pharmaceutical industry (by ensuring that proper financial reward is available for truly innovative and worthwhile products). We suggest that it is in the interests of NHS management and the pharmaceutical industry to reach an accord on mechanisms and standards of evaluation such that the NHS decision-making process can be fully informed. The relevant issues to be considered include the consequences of proposed innovative therapies on clinical outcome, patient quality of life, patient satisfaction, cost and cost-effectiveness. The ultimate and most important improvements would be experienced by the patients.