NICE's Dillon: Change required to manage the coming 'revolution' in medicine

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The coming revolution in medicine will stress and challenge health systems around the world, according to Sir Andrew Dillion, chief executive of England's National Institute for Health and Care Excellence (NICE).

Speaking at last night's annual Medicines New Zealand parliamentary dinner, Dillion said companies with personalised medicines, including potentially curative gene and cell therapies, need to consider how they will share risks and uncertainty with decision makers and contemplate how "they operate for the return on investment they will make."

Dillion said decision-making agencies like NICE will need to evolve their processes in response to new technologies.

"Healthcare systems want products to patients as quickly as possible - generally speaking," he said, adding the risk and evidentiary uncertainty associated with new technologies like gene and cell therapies means new approaches will be required.

"This will require collaboration or the benefits will not be derived," he said.

Dillion said evaluating and funding new technologies like gene and cell therapies is only part of the problem because they also will deliver a "truly disruptive" level of change to the jobs of people working in the health system. "This is hard," he said, pointing to the impact of technology convergence.

The NICE chief executive, who has held the position since 1999, said this issue was behind the creation of its Accelerated Access Collaborative (AAC).

The AAC was created last year. It is overseen by an appointed partnership comprised of policy-makers from multiple government departments, including health, regulators and industry, as well as academia, patients, clinicians, the pharmaceutical, medical device, diagnostic and digital health industries.

It also has published terms of reference that cover its mission, role, membership, the regularity and transparency of its meetings, and even attendance.

The terms of reference clearly focus its work on all 'transformative' technologies with the goal of ensuring "strategically important, cost-effective products" reach patients "as rapidly as possible".

"We need to understand and dismantle barriers to access to innovative treatments," said Dillon. "The AAC starts the conversation early about where a treatment fits in the pathway and how it needs to change."

Dillon also highlighted the importance of transparency in decision-making, particularly when it comes to prioritising. "This means something else is missing out - that is the reality," he said.