Test 3 October, 2017

Is the NHS ready for medicines of the future? - part I

Medicines developed by pharmaceutical companies help patients all over the world to live longer, healthier and more productive lives.

Today, medical advances support the NHS to avoid 10,000 more deaths from heart attacks, avoid millions more emergency admissions for asthma, and double the cancer survival rate in the last 40 years. The life-saving and life enhancing medicines that pharmaceutical companies have developed also make it possible for people to go back to work who otherwise couldn’t, supporting their families and communities.

What’s more, we’re also in a golden age of new medicines. Our medicine development teams never stop looking for the next breakthrough. Innovation in treatments for conditions such as cancer, Alzheimer’s and rare diseases have the potential to change healthcare globally, with the UK a world leader in researching and developing new medicines. There are currently 7,000 new medicines being developed globally.

Once developed, we need to make sure these new medicines are available to patients.

Two things have happened in the last decade that have made this last step challenging. As our teams of scientists have tackled new frontiers in the battle against disease, so the cost of generating the evidence we need about these medicines has gone up. The less is known about something, the more our scientists have to work to establish facts about how the medicine will work. And at the same time, as we all know, an ageing population has become more prone to chronic diseases and has meant a larger population for the NHS to treat.

We want the NHS to be able to keep pace with the amazing medical advances that our members’ unique expertise and capabilities are working to make available as usable and safe treatments – immunotherapies, CAR-Ts, cell and gene therapies, antibacterial monoclonal antibodies.

So we need to find new ways to work with the NHS when it is trying to transform while simultaneously having some of the lowest increases in funding in its 60 year history. And we have to do this while constantly re-investing in our battle to improve human health. Because diseases never rest, and so neither do we.

The Life Sciences Industrial Strategy, published over the summer, was an impressive document. The ABPI contributed to the development the strategy, which was coordinated by Sir John Bell. It has the NHS at the heart of the solutions to make the UK the best place in the world for the life sciences sector, making clear recommendations for how to make sure patients are able to access the medicines of the future.

The first is to evolve the way that medicines are assessed as cost-effective. By making systematic judgements that incorporate a wide range of factors, NICE’s assessment system would be more suitable for different types of medicine, would be fairer for different patient groups and better able to reward the medical innovation that expands into new frontiers. Companies need to anticipate, as far as possible, and then generate the evidence that such a system will require – this may mean investing in new types of studies, for example.

Secondly, once a medicine is shown to be cost-effective this means that it is a better use of the NHS’ funds to use it than to continue with alternative treatments. That means both patients and taxpayers should expect the NHS to use these treatments throughout the NHS as quickly as possible. Budgeting that incentivises cost cutting in one area of the NHS – even if that is bad for another part – means that this doesn’t currently happen. More flexible budgeting and commercial models would help address this, alongside working in partnership to introduce complex technologies that can transform how patients experience their care. It’s intimately linked to the NHS’ transformation and our members are increasingly stepping up to that challenge, but there is much more to do in this area.

Finally, because the risks and budgets for all involved are significant we are fortunate that here in the UK we have a really important mechanism to enable us to agree a long-term framework for medicines policy. It’s called, misleadingly, the Pharmaceutical Price Regulation Scheme (PPRS). Misleading because it is a much broader agreement encompassing more than just issues on pricing, and it’s helped to regulate the relationship between government and the NHS and our industry for almost as long as the NHS has existed. The current agreement has successfully limited the NHS budget for newer medicines despite the significant increase in the number of prescriptions, delivering fantastic value for money for all of us as taxpayers. But the UK has done less well at utilising this mechanism to enable it to invest in bringing NHS use of newer medicines up to the level of other countries in Europe, which would have benefitted all of us as patients or potential patients. We believe the next agreement should seek to provide certainty and stability to all parties as regards costs and risks, but be much more ambitious in what it delivers for patients.

The Life Sciences Sector Deal is an opportunity for the Government to work with us and the NHS to deliver these three reforms. With the Life Sciences Strategy now published, we are hopeful the Government will take this and work to put in place a future-proof system that encourages investment in new medicines and ensures these medicines get to patients.

This is crucial if we are serious about delivering a world-class health service now – and into the future.