America has emerged on top in what is being billed as the most comprehensive assessment yet of international variations in pharmaceutical use.
The new assessment, produced for the British government, looked at the uptake of drugs for 14 diseases in 14 countries, measured on volume of use per capita. It ranked Spain second, with France in third and the UK down in eighth.
It stresses that high usage does not necessarily equal good performance, nor does low usage indicate a failing. However, the UK’s Health Secretary Andrew Lansley confirmed at the unveiling of the report that his government will be bringing in a previously mooted £50 million fund to increase access to cancer drugs.
Lansley said it was “a scandal that we are strong in cancer research and participation in clinical trials in the UK, yet NHS patients aren’t always seeing the benefits from the research swiftly enough”.
There have long been complaints from some commentators that the UK has worse access to drugs than other countries. Often, this is blamed on the National Institute for Health and Clinical Excellence, which assesses the cost effectiveness of many drugs and decides whether they should be available on the UK’s public health service.
Blaming NICE is probably unfair, as data shows the institute approves more drugs than it blocks. Also, the report notes that “positive guidance does not always automatically result in higher than average use of medicines. It is notable that some categories of drug which have received a strong NICE endorsement are still used at significantly lower levels than in other countries, for example, for hepatitis C treatments or some cancer drugs.”
Mike Richards, the UK’s National Cancer Director and the man who complied the report, does end up ranking the UK tenth for cancer drug usage and eighth overall.
“For some disease areas, high usage may be a sign of weaknesses at other points in the care pathway and low usage a sign of effective disease prevention. Equally, for others, low usage may imply that patients’ needs are not being met effectively and high usage may imply that patients are receiving the best treatment,” he writes.
Click the table below for a full size version.
