Who decides the price and availability of NHS medicines?

Written By Vivek Kotecha & Professor Karl Claxton

Who decides the price and availability of NHS medicines?

Outrage and dismay over the prices charged for new medicines are becoming an increasingly regular occurrence in England. Most recently it was over a life-extending drug for cystic fibrosis, Orkambi, with a hefty price tag of £105,000 per patient per year – far higher than NHS England’s counter offer of £500m over 5 years across all patients.

The number of disputes between the NHS and pharmaceutical companies over the price of new drugs is likely to increase in future. This briefing summarises the key forces determining the price and availability of new medicines in the NHS. It explains the tension between pharmaceutical companies, purchasers (e.g. the NHS), and patients’ representative groups.

Vivek Kotecha & Professor Karl Claxton
Vivek Kotecha

Vivek was CHPI's Research Manager from 2016 to 2020 ─ leading on a number of high-profile projects in this time. Before coming to CHPI he worked as a manager in Monitor and NHS Improvement analysing and reporting on the operational and financial performance of the provider sector. Prior to that he worked as a management consultant at Deloitte for 4 years.

Professor Karl Claxton

Karl Claxton is a Professor of Economics at the University of York. He was a Harkness Fellow at the Harvard School of Public Health and from 1999 until 2007 he held an adjunct appointment at Harvard as an Assistant Professor of Health and Decision Sciences. His research interests encompass the economic evaluation of health care technologies. He has served as a member of the National Institute for Health and Care Excellence Appraisal Committee since 1999.

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