The government’s drug pricing policy is falling apart messily

Promises made in the heat of an election campaign have a way of coming back and biting politicians. In the run up to polling day in 2010, the Tories Andrew Lansley and David Cameron promised a new pot of money to provide anticancer drugs that would otherwise not be available because they had failed to meet criteria on cost effectiveness.1 How could this be squared with their support for the National Institute for Clinical (now Care) Excellence (NICE), which makes those decisions? By explaining—as one of Lansley’s more cogent spin doctors obligingly did for me at the time—that the Cancer Drugs Fund was a temporary device to act as a “bridge” between the present and a future in which drugs would be priced by the value they provided.

Thus were two incompatible policies—one unashamedly populist, the other obscure enough to sound impressive while eluding precise definition—harnessed together. They are now rather messily coming apart. Nobody knows what will become of the Cancer Drugs Fund when the three years’ funding promised by the coalition government comes to an end; and value based pricing, promised for the start of …