NHS England accused of interfering with hepatitis C drug

Blenheim CEO is outraged at continued NHS England interference in the process to decide whether a cure for hepatitis C should be made available to patients on the health service.

In January, NICE approved Gilead’s drug, Sofosbuvir. Despite its cost – £35,000 for a 12-week course – they decided that it was of value because of its high cure rate, fewer side-effects and potential to prevent the need for costly liver transplants. But there was outrage after they agreed to a request by NHS England for an unprecedented six month delay in implementation. There is further concern that an early access scheme, so patients with cirrhosis did not have to wait the six months, has not yet started.

Now officials at NHS England have been accused of interfering in a process to decide whether a drug which can cure hepatitis C should be made available to patients on the health service. Harvoni, which is a combination of two new generation hepatitis C drugs, is currently being appraised by the National Institute for Health and Care Excellence. But at a meeting at NICE on April 1, it is claimed that two senior NHS England officials reminded those attending that they had to take into account the cost to the health service when deciding whether to approve any treatment. This is, in fact, not true. NICE does not focus on affordability but rather on cost-effectiveness.

It is also claimed that the officials suggested that if NICE reached the “wrong” decision in appraising the drug, they would seek judicial review. Charles Gore, chief executive of the Hepatitis C Trust, said “I definitely felt they were suggesting that if NICE did not conform to what they would like to see happen, then they would potentially take judicial action.”

John Jolly, chief executive of Blenheim said “Scotland and Portugal have new treatment for people with hepatitis C why not England? Personally I’m ashamed to live in a country where we are failing people so badly.”

The rising tide of deaths from hepatitis C, a preventable and curable virus is a scandal. It is absolutely unacceptable that half of those living with hepatitis C are still undiagnosed and a mere 3% of those infected are treated each year. There is a clear link between hepatitis C and deprivation. Hepatitis C has been overlooked, ignored and under-prioritised and underfunded resulting in spiralling hospital admissions and deaths. This is because the majority of people living with, and dying from, the virus are from the most marginalized, vulnerable, deprived groups of society.

If the health service is to reduce health inequalities and “improve the health of the poorest, fastest”, hepatitis C must be addressed.

As many as 214,000 people in the UK are believed to be infected with hepatitis C. It can lead to cirrhosis of the liver and cancer. Some patients need to have transplants. And in the worst cases, sufferers die. Until recently the treatment lasted up to 48 weeks and had serious side-effects. The new generation of drugs have been hailed as a breakthrough. There are far fewer side effects and a 92-98 per cent cure rate in some cases. At the April 1 meeting the NHS England officials claimed it would cost £1.3bn if approval was given. Mark Thursz, professor of hepatology at Imperial College London, said this was “a gross exaggeration”: “The likely cost is £300m to £400m.”

NHS England asked for a meeting this month to be delayed while they reassessed their figures. In the meantime, doctors are finding themselves unable to treat their patients.

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