Wind of change

PB Senior Account Manager Tomas Morel writes…


Tomás MorelWhat does the future hold for NICE?

2019 is proving to be a turbulent time beyond any scale imaginable. While on the political stage Brexit saturates and exhausts the mental bandwidth of a nation; at a much smaller scale, a number of events are taking place which are primed to alter the access landscape of novel therapies in the years to come. The recent announcement of Sir Andrew Dillon’s departure, NICE’s long serving Chief Executive is one said event.

Over his tenure at the arms-length body, Sir Andrew spearheaded what experts may describe as the ‘systematic rationalisation of access to medicines’. It’s important to note the enormity of the task he took on in 1999, creating a health technology assessment body for the world’s largest single healthcare system, and putting himself in the firing line of both patient groups and industry. To get such an organisation up and running is extraordinary, to still be in post twenty years later is unprecedented. Among his crowning achievements, you may count the introduction of a robust assessment methodology, the use of quality-adjusted life-years (QALY) – and the thresholds set against it to deem what is cost-effective for the system. No easy feats.

Sir Andrew’s leadership is regarded as being an incredibly successful one, which has led to NICE’s ability to project a profound influence not only among our continental neighbours, but across the globe. In light of such strong leadership, the trailblazer’s career has certainly placed him as the focus of both praise and criticism by industry leaders. From the early bouts with Glaxo Wellcome to the more recent proceedings with Vertex, criticism has been relatively persistent.

Many may argue that said persistence, combined with the birth of a barrage of new forms of treatments, have pushed NICE to reflect on how their methodologies can best stay ‘in tune’ with the times. This has materialised in the form of the recently announced review of NICE’s evaluation methodologies – another exciting development we have witnessed this year. Despite the process being a long-drawn one, with initial consultation stages scheduled to take place next year, there is an air of excitement among manufacturers as to what the potential change in landscape may bring. While the review is not expected to cover ‘QALY thresholds’, it will however, cover discussions on how quality of life is incorporated into economic models, and how NICE will consider this data – among other subjects.

Cue Scorpion’s musical hit which lends this piece’s title; and you will find that – alike its lyrics – many market access specialists may find themselves euphoric at the potential that these changes hold. The responsibility of directing said change will fall upon whoever takes the helm at NICE, and we will have to wait until the autumn to learn more about this appointment. As surely the profile of the appointee will feed speculation as to the character of the methodology review. Whoever ends up taking a step forward will have gargantuan shoes to fill. The team at PB Consulting will be close to the action, to ensure this and future intelligence informs the strategies of the wider health community. We would be delighted to learn more about your expectations for what 2020 may deliver – don’t hesitate to get in touch!


PB Consulting’s Senior Account Manager, Tomas Morel, works closely with manufacturers, healthcare professionals and policy makers to ensure the appropriate adoption of high cost, high value therapies. If you wish to get in touch, feel free to email him at: