Meeting of the Parliament 20 June 2018
We all want patients to be able to access the treatments that they need without delay. It is unthinkable that patients’ health is deteriorating while medicines that could help them are not being used.
It is right that Parliament works to ensure that medicines reach the people who need them. The best long-term solution is to improve the frameworks that surround those decisions, as there will never be time in this chamber to properly consider individual medicines with the urgency that patients and all the organisations and individuals who have campaigned long and hard require and deserve. The amendment that I lodged was clear that all patients need to have confidence that there is a trusted and transparent system for regulating the approval of all new medicines.
Today, Cancer Research UK has emphasised that the SMC plays a vital role in assessing the clinical and cost effectiveness of new medicines independently of the Scottish Government. It is right that there should be an independent process. Ultimately, the efficacy of individual medicines must be evaluated by clinical experts.
I support the motion before us today. Improvements have been needed to our overall frameworks for approving new medicines. The motion rightly highlights that the Government has already committed to improving aspects of negotiating with drug companies.
I acknowledge that we have seen progress towards implementing the recommendations of the Montgomery review over the past year, which the Government’s amendment details. I will support the Government's amendment on that basis, although I appreciate the real concerns that progress has not been fast enough or always clear enough. I also wholly support the position that
“pharmaceutical companies should offer NHS Scotland fair prices and should properly engage with health technology assessments”.
I am glad that the manufacturers of Perjeta are making progress on resubmitting to the SMC, and I implore the manufacturers of Orkambi to do the same. There is no time to be lost.
I will also support the Conservative amendment that proposes that we remove unnecessary barriers to treatment. I am open to some potential reform of the role of the patient access scheme assessment group, although I am not wholly convinced by submissions to the Montgomery review by pharmaceutical companies that said that they want to see the assessment group
“develop their role from gatekeeper to enabler”.
I also have reservations about urging NHS National Services Scotland, the SMC or the Government to move into negotiations that are even less transparent than current processes. Decisions about procurement should always be taken as transparently as possible.
If we are to urge the Scottish Government to take action beyond the SMC process, we cannot rule out other legal routes to procure medicines. The campaign group just treatment wants to see the Scottish Government make use of its powers to pursue a Crown use licence in some cases. I have raised that possibility with the cabinet secretary recently. I appreciate that that might not be a quick solution, but it has the potential to lead to much-needed long-term change on drug pricing.
We cannot ignore the fact that manufacturers have the latitude to change their stance on price. I very much hope that Roche has reached a position that allows the SMC to approve Perjeta for general use, and I encourage Vertex to do the same on Orkambi.
As the just treatment campaign has pointed out, although we cannot alter the efficacy of drugs to make them more cost effective, the price is variable, and the key driver of price will be the patent-backed monopoly that is held by manufacturers. The “Just treatment” campaign has worked with inspiring campaigners such as Dunise MacIver, who have spoken honestly and openly about the difference that accessing Perjeta would make to their care and treatment. Last week, my colleague John Finnie highlighted the experience of his constituent, Hannah McDiarmid, who has grown up with cystic fibrosis and lives with two hours of physiotherapy a day to clear mucus from her chest and lungs.
It is incredible that so many constituents have put so much into campaigning for access to treatment when their own health must be their priority, and they manage really complex treatment regimes. They are inspiring us, but they should be able to focus entirely on their health and wellbeing. We must get access to medicine right in the first place so that no one has to lose time that they could be spending with their families because they are putting their energy into leading campaigns for the treatment that they need.
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