Alternative access schemes for pharmaceuticals: bypassing scrutiny?

Who decides if new drugs are funded by the NHS, and based on what criteria? Many countries set up specialized "health technology assessment" (HTA) agencies to make recommendations on new drugs' cost to the health systems and benefit to patients. In recent years, however, expensive drugs have been funded despite failing HTA or never being evaluated, via alternative access schemes, such as the Cancer Drugs Fund in England. Even though spending on these schemes is growing, little is known about them. I will study why alternative access schemes emerged, how decisions in them are made, and what this means for patients and public finances. I will provide an overview of alternative access schemes in Europe and a detailed analysis of the procedures and criteria they use in selected countries. The project will contribute to debates on affordability of new medicines.