The adoption of expensive new drugs by the NHS in the UK is doing patients more harm than good, according to a study that urges a sharp reduction in the price pharmaceuticals companies are paid for their products.

Research by the University of York found that lives were being lost and quality of life diminished because spending on overpriced drugs was diverting resources from other kinds of health care that would produce more benefit. The maximum threshold for judging a medicine cost-effective should be more than halved, the report said.

“The increasing pressure to approve new drugs more quickly at prices that are too high will only increase the harm done to NHS patients overall,” said Karl Claxton, co-author of the report.

The findings carry weight because health economists at York played a leading role in developing the model used by the National Institute for Health and Care Excellence (Nice) to judge which medicines offer value for money to the NHS. Their new research will intensify debate over the price of drugs in the UK and beyond, a month after NHS England announced it would remove funding from several cancer therapies to contain rising costs.

Nice currently has an upper threshold of £30,000 (Dh169,662) per quality-adjusted life year — a measure of the extra length and quality of life provided by a drug — for recommending a treatment. Sometimes it goes above that level.

According to the York study, any intervention costing more than £13,000 per-QALY risks causing more harm than good based on a study of health spending and outcomes across the NHS. The report said that £10 million spent on a new drug approved at Nice’s current upper threshold would produce 333 extra quality-adjusted life years for patients who received the treatment, but cause the loss of 773 to patients denied other forms of care because of insufficient resources.

An example of this might be money spent on a cancer drug that could otherwise have been used to fund prevention programmes, earlier diagnosis or surgery and radiotherapy.

Tough sell

Professor Claxton, one of the UK’s foremost health economists and a long-time adviser to Nice, acknowledged it would be difficult for politicians and health care professionals to make the case that denying patients a medicine could result in improved overall health outcomes.

But he added: “There has to be some honesty and accountability if, for political reasons, we are prepared to pay half a million pounds for [a drug] that is not very effective and, as a result, these people over here are going to suffer from increased mortality and a reduced quality of life.”

The York research highlighted the Cancer Drugs Fund — a special scheme set up by the coalition government to provide extra money for cancer medicines — as a glaring example of waste. For every QALY gained from the fund, five were lost, the study found.

Nice said the existing threshold represented a “pragmatic compromise” between ensuring fair and equitable access to NHS treatments and encouraging use of innovative drugs. “The question is how to balance investing in the cutting edge of medicine with more routine care,” said Sir Andrew Dillon, Nice chief executive.

“Unless you think that drug companies will be prepared to lower their prices in an unprecedented way, using a threshold of £13,000 per QALY would mean the NHS closing the door on most new treatments. At the other end of the spectrum, we obviously can’t just say yes to anything and everything... We’ve achieved a balance between these two extremes that reflects what we believe the public expects the NHS to do.”

Paul Catchpole, director of value and access at the Association of the British Pharmaceutical Industry, said the study was “of some academic interest but should not be used as a basis for policy or decision making”.

“If a threshold of £13,000 were applied to decisions about all health care interventions then many vital services would cease to be considered viable including A&E, palliative care for dying patients, and maternity services for new-borns and their mothers.”

Catchpole said the industry was committed to working with the government and the NHS to keep the annual drugs bill of roughly £14 billion sustainable. Drugmakers paid the Department of Health £229 million in rebates last year as part of a deal to cap growth in spending.

— Financial Times