Deal to speed UK uptake of new medicines revealed
pharmafile | March 17, 2006 | News story | |Â Â Â
A new deal between the UK government and the pharmaceutical industry to ensure faster and wider access to new medicines is likely to be struck by the end of 2006, the head of the ABPI has said.
Richard Barker, director general of the pharma organisation said the issue had been at the top of the industry's agenda for some time, and said formal discussion with ministers as part of the Ministerial Industry Strategy Group (MISG) was progressing.
Barker revealed the plans exclusively to Pharmafocus on hearing our survey of industry executives placed uptake of medicines/regional variations in prescribing as the number one problem for pharma in relation to the NHS.
He commented: "This is a major subject of discussion and joint work with the government through the Ministerial Industry Strategy Group.
"It is one of the principle issues we are working on together, so I think thats a very positive sign that ministers recognise this is a big issue."
The MISG brings together UK pharma industry leaders and top officials from the MHRA, Department of Health and other departments, and has been meeting twice yearly since November 2001.
The MISG is increasingly influential in formulating plans for collaborative action to assist the pharmaceutical industry, while balancing these demands against the needs of the NHS.
There is little doubt that the UK lags behind almost all other western European nations in its uptake of new medicines, a level estimated to be around half of that seen in Germany and a third of that in France.
NICE was set up in 1999 to appraise new medicines and speed up access to them, but has had limited success in this second goal, and is itself often cited as a further barrier to access.
Many in the NHS still believe slow uptake is not necessarily a bad thing, but the ABPI has long argued it is unfair and seriously detrimental to patient care – as well as being bad for its UK business.
The ongoing controversy surrounding access to the breast cancer drug Herceptin has helped push the problem up the political agenda, making it a highly emotive case of life or death for women denied access.
Now the government seems ready to finally act on the industry's longstanding complaints, but Barker said this could only be done by understanding and tackling the root causes.
Outlining what he sees as the main factors behind slow uptake and postcode prescribing, he said: "It is partly because we dont have a mechanism that reinforces NICE implementation. Another part of it is PCT budgets, part of it is, frankly, groups of doctors within the overall population who are very resistant to using new technology of all kinds."
Last year Nigel Crisp, chief executive of the NHS told a select committee inquiry into cancer services that there was 'some room for professional differences' in terms of cancer prescribing, but said NICE guidance must also be followed.
It is this seeming confusion or contradiction that Richard Barker said must be addressed.
"For the government to drive a real change, they will have to square the circle between their desire to give maximum local decision-making power, and their desire to see the NHS reach a consistent standard nationally."
The MISG is carrying out a number of detailed investigations into the causes of postcode prescribing and slow uptake of new medicines, with conclusions and recommendations to be made at its next meeting in November.
Barker indicated that all sides were open to ideas about how to address the problem.
"I think we may need mechanisms for some of these high priced medicines to be able to bypass the local budget triage process. I dont know, I am just thinking of solutions here, but we are on track to working out the problem with senior government and NHS officials."
Demonstrating confidence that real progress would be made, he concluded: "We hope to have reached some conclusion on this by the end of the year."
Notes from the most recent meeting of the MISG in February show a number of strands of research now being undertaken in collaboration between the industry and government. These include two Uptake Variation Studies, one mapping the variations across therapy areas and geography, the other looking for local factors influencing uptake.
Against the background of a financial crisis in many NHS trusts, the group is aware that finding money to fund faster uptake of expensive new medicines is a key question.
One of the sub-groups exploring possible solutions, led by the DH's Felicity Harvey and GlaxoSmithKline UK's general manager, Eddie Gray, said the final plan must identify where extra money should come from.
The group suggests that 'disinvestment in less cost-effective treatments and technologies' should be encouraged to free up money, though this is a tactic already employed in the NHS, and has demonstrated finite potential to generate savings.
'Postcode prescribing/access to new medicines' was voted the number one issue for pharma in relation to the NHS in a newly published Pharmafocus survey of the industry.
