Fears over watchdog’s rationing of costly drugs

FEARS that the State’s new watchdog on health and social services will ration expensive drugs were raised yesterday by cancer specialist Professor John Crown.

The interim Health Information and Quality Authority (HIQA) is expected to be established on a statutory basis next month.

The Health Bill, going through the Oireachtas, allows the authority to evaluate the clinical and cost effectiveness of health technologies, including drugs.

Prof Crown said the British National Health Service set up a similar body a few years ago called the National Institute for Clinical Excellence (NICE) and that had become famous for rationing expensive treatments.

He pointed out that NICE had restricted a number of drugs for treating breast cancer in women.

Prof Crown said he was concerned that the cost effectiveness of drugs was the principle agenda item being followed by HIQA.

And, he said, if the Minister of Health and Children, Mary Harney, wanted to clarify the issue why didn’t she ensure that cost effectiveness was not an issue for the authority?

“We all support an agency that inspects hospitals, doctors and nursing homes, but the remit of this authority is going to go much wider if left unchecked,” he warned.

He pointed out that a new kidney cancer drug had been subjected to a health economic analysis by the authority before Christmas. The drug had been passed after a delay, he said.

The new chief executive of HIQA, Professor Tracey Cooper, stressed that the evaluations would not be made purely on cost grounds.

At a press briefing in Dublin yesterday, Prof Cooper, a qualified medical doctor and formerly head and director of operations at the National Health Service Clinical governance support team, said quality of life for the patient would also be considered.

“In order to identify whether a drug or a device is suitable for the healthcare system we have to take into account the quality of life and the quality of end of life, depending on the nature of the condition, not just the cost,” she said.

Asked why a drug already approved by the Irish Medicines Board (IMB) or the European Medicines Evaluations Agency (EMEA) needed to go before a third party and delay its availability to the public, Prof Cooper insisted that other activities would not be duplicated.