Patient Access Schemes in the New NHS RJW partners

RJW & partners
Monday 5th November 2012
14:15 – 15:15
Patient Access Schemes in the New NHS
Spoors J, Brown C, Johnson N, Rietveld A

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What is a Patient Access Scheme (PAS)?
Patient Access Schemes (PAS) are designed to ensure patients
can gain access to medicines which are likely to have a high cost
and might not be deemed cost-effective by payers
Source: Dima Yagnyuk and Benjamin H Byron, from The Noun Project
Payers face budgetary
constraints
Manufacturers have
commercial objectives

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MS Risk-
Sharing
Scheme
Velcade®
Risk-Sharing
Scheme
Renal Cell
Carcinoma
Discount
Scheme
2002 2007 2009
Financially Based
Easy to administer
Outcomes-Based Financially-Based
PAS are not a “new” concept

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Two Part Patient
Access Scheme
Part A – 12.5%
Discount on list price
Part B – Possible
future rebate linked to
outcome of head-to-
head trial against gold
standard competitor
Reduces financial
uncertainty at time of
appraisal
Provides payer with
long-term “guarantee”
on clinical
effectiveness
The essence of PAS – reducing uncertainty at
launch

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List of approved medicines with a PAS
TA Ref Treatment Indication Company
TA 129 Bortezomib (Velcade) Multiple myeloma Janssen-Cilag
TA 155
Ranibizumab (Lucentis)
Macular degeneration (Acute wet AMD) Novartis
TA 162 Erlotinib (Tarceva) Non-small cell lung cancer Roche
TA 169 Sunitinib (Sutent) Renal cell carcinoma Pfizer
TA 171
Lenalidomide (Revlimid)
Multiple myeloma Celgene
TA 176 Cetuximab (Erbitux) Metastatic colorectal cancer (first line) Merck Serono
TA 179 Sunitinib (Sutent) Gastrointestinal stromal tumour Pfizer
TA 180 Ustekinumab (Stelera) Moderate to severe psoriasis J&J / Janssen-Cilag
TA 185 Trabectedin (Yondelis) Advanced soft tissue sarcoma PharmaMar
TA 186 Certolizumab pegol
(Cimzia) Rheumatoid arthritis UCB
TA 192 Gefitinib (Iressa) Non-small cell lung cancer AstraZeneca
TA 215 Pazopanib (Votrient) Advanced renal cell carcinoma GSK
Source: NICE website www.nice.org.uk – Accessed 22nd October 2012