The NHS’s budget is fixed, or even falling, and we have more and more exciting new cancer treatments and immunotherapies are really at the vanguard but they do cost a lot of money, possibly justifiably because they do benefit patients usually but we need to bear in mind that the money that could be spent on them could also be spent on other patients’ health elsewhere in the NHS. So we just need to get it right to make sure that we’re benefitting all the patients with the money that we’ve got.

Do you think NICE get it right?

I think they have a really challenging job so I’m sure they don’t get it right all of the time but what is clear is that they have a really rigorous, internationally leading process for health technology assessment which means that they do to the best job of working out what should and shouldn’t be paid for.

Is part of the issue that drug companies are charging too much? How do we tackle this?

It’s a balance. It’s important that we don’t lose the incentive to develop new cancer treatments and it’s really important that we keep moving forward. So we need to incentivise industry as well as academics to develop new exciting novel treatments. But we also need to bear in mind that it’s taxpayers’ money that is funding the whole of the NHS so we just need to make sure it’s proportionate.

Is the situation different in Scotland?

They are different organisations so in Scotland we’ve got the Scottish Medicines Consortium which follows a very similar process to NICE in England. The methods are broadly similar, the processes are a little bit different. They don’t always come to the same conclusions but more often than not they ally and their objectives are the same.

So what are the key points from your talk?

There is now a huge influx of new immunotherapies for lots of cancer indications and NICE has really got its hands full over the next year to deal with all of these. NICE really wants to be looking at things quickly, as soon as they have a marketing approval, but that’s a lot of work to assess all of the evidence and as NICE is looking at things earlier the evidence that they have to work with is less certain so the challenges are greater .So it’s going to be a real test case for NICE and other reimbursement decision makers, the immunotherapies.