Inclisiran and embedded conflicts of interest

investigations are worth it

It took us over a year and a massive amount of work, but it was brilliant to work with @deb_cohen (twitter handle) in this investigation into inclisiran, a drug to treat cholesterol. As you will see in the long form piece published in the Pharmaceutical Journal, there are questions about the evidence for the effectiveness of the drug in the population it was being aimed at; the order that the government chose to do things in (ie announcing the partnership and organising roll out before NICE had actually approved it), the pressure it put NICE under, the interactions with Novartis, the unsubstantiated numbers in the press release, and the following push into practice - as well as the changes to the GP contract designed to increase prescribing of it. A fact not lost on Novartis.

Since that was published in the PJ, we received a further batch of FOIs that allowed us to establish more information about the government co-ordination of the roll out of this drug. See BMJ here. My personal view is that NICE needs not just to be independent but also be seen to be independent. Sitting down with various Lords, Novartis and OLS to discuss ‘oversight’ of the rollout - is that really a good idea?

Prof/Sir David Haslam is quoted and I think makes huge sense.

It’s easy to forget that NICE is relatively recent. It was set up to stop cost ineffective stuff getting into the NHS, benefiting no one and diverting resources that could work better. I remember giving a talk, with Iain Chalmers, to the citizens’ panel that was being set up, and marvelling at the ambition to do big, transparent, evidence based, patient centred medicine.

We are going backwards. That’s bad for everyone who needs the NHS.