Innovation in European healthcare – what can Sweden learn? - LIF

There still exists large regional variation in
uptake of NICE-endorsed products
IMS Health report “Bridging the gap: Why some people are not offered the medicines that NICE
recommends” (2011) commissioned by Department of Health found fundamental gaps in the
uptake of NICE-endorsed medicines within the NHS.
The main reasons for these gaps according to this report are:
1. Insufficient diagnosis (e.g. only 32% of non-hip fracture patients had a clinical assessment
for osteoporosis/fracture)
2. NICE-required tests were not done (in this context 75% of interviewed oncologists said
access to, or the cost of, biomarker tests were major barriers to the use of personalised
medicines)
3. Varying access to specialist medical expertise (e.g. in a multi-centre audit, 18% of
people with glioma that could have received carmustine, chemotherapy, were not offered it,
because their cases had not been discussed within the relevant multidisciplinary team)
4. Insufficient capacity to deliver (e.g. very long waiting lists at some memory clinics and
some liver clinics delay initiation of treatment for Alzheimer’s disease and HCV)
5. Commissioning is deficient (thus commissioners and providers argue over who should
pay for those drugs that are initiated in secondary care but followed up in primary care)
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