And the answer is…..nothing has been decided.
On very rare diseases, the government has “not, at this stage, formed a final view”. In terms of having more than one price for a drug “whilst we are not ruling out any options at this stage, we intend …to explore the potential alternative approaches”. Where there is insufficient evidence to allow a full assessment, the government has “not yet reached a final view on our preferred approach”. In terms of balancing rapid access and affordability, the government is “still at an early stage of our work”.
What is clearer is that burden of illness, therapeutic improvement and innovation and wider societal benefits will be weighted under VBP. The government notes that “the responses are generally consistent with the possible approach proposed in the consultation, whereby the Burden of Illness of a condition is defined as the health loss currently suffered by patients, and Therapeutic Innovation and Improvement is measured on the basis of the quantity of health gain provided by a Treatment”. For each of these, the government response notes that the weights will be based on the best available evidence, following a programme of research and that the system will be completely transparent.
One final point of interest. Annex A gives a list of all 153 organisations that responded (there were 188 responses in all). It reads like an A to Z of pharmaceutical and biotechnology companies, with only three academic departments listed; HEDS, LSE and SHTAC. Why are economists not interested in this?