An MHK has warned that a “cost neutral” test is blocking access to treatments such as weight loss jabs that have long-term financial and health benefits.
Joney Faragher said the current approach to NICE technology appraisals, including drugs such as Wegovy and Mounjaro, risks leaving the island behind as the UK NHS rolls out the treatments following clinical approval.
“Most NICE appraisals aren’t cost neutral in the short term,” she told Tynwald. “Implementation is being quietly limited here. It creates the appearance of compliance with NICE standards, while allowing non-implementation on financial grounds.”
She warned that focusing on short-term budgets ignores the longer-term benefits of preventive medicine.
“NICE does not assess cost neutrality. It assesses cost effectiveness over time in the long term. Many of these treatments are approved precisely because they’re expected to reduce future demand on the health service, preventing more serious illness and improving long-term outcomes.”
Medications
Ms Faragher said: “These include treatments people will recognise, such as the weight-loss medications like Wegovy and Mounjaro, now introduced in the UK NHS following NICE approval.
“These are not cost neutral interventions in the short term. They require upfront investment and system capacity to deliver.”
She added: “We’re ruling out the very interventions that could deliver the greatest long-term benefits, both for patients and for the sustainability of the system.”
Health and Social Care Minister Claire Christian defended the mandate, saying it must balance clinical ambition with fixed annual budgets.
Ms Christian explained the tension between clinical recommendations and budget constraints: “As a government, however, we also have a statutory responsibility to ensure that decisions are affordable and within a fixed annual budget.
“And those two things are not the same, and the mandate is deliberately honest about the tension, rather than obscuring it.”
She did however say that the position is not static: “As financial headroom will improve, further treatments can and should be progressed through the agreed prioritisation process.”