NHS: pharma needs to help more
pharmafile | November 12, 2012 | News story | Sales and Marketing | CCGs, NHS, pharma
A variety of senior figures in public health set out how they want the pharma industry to do more to help improve patient outcomes at last week’s ABPI Member Conference.
Their pleas at the event, hosted at the BMA’s HQ in London, ranged from more pre-launch information about medicines to greater sharing of knowledge about products generally.
Keith Ridge, the Department of Health’s chief pharmaceutical officer, called the regional variation in the use of medicines in the NHS ‘inexplicable’.
And he insisted that the new tag of ‘medicines optimisation’ which the NHS is now using was not simply the old ‘medicines management’ repackaged.
“Making sure we’re using well what we’ve got will begin to free up some space for new technologies,” Ridge said.
But he urged pharma companies to help further. “The knowledge you have around individual products could be shared even more.”
Asked by a delegate what would happen in the NHS under the new arrangements to the majority of medicines which are not NICE-recommended, he answered: “The new system will underpin all medicines use.”
While much has been made of looking at the cost of whole-life care rather than individual costs such as a drugs bill, there was still need for a change in culture, said Jonathan Mason, clinical adviser (medicines) at NHS North East London and the City.
“The big challenge is how we break down the silos,” Mason admitted. “How we break down that thinking among FDs [finance directors] and others – for example, ‘you’re saving money on admissions but spending too much on medicines’.”
Mike Farrar, chief executive of the NHS Confederation, told the ABPI audience that there were both pros and cons to the new NHS system put in place by the Health and Social Care Act, with pharma able to help with solutions on areas like cost saving.
“We’re running out of road in terms of transformational change and that’s got to be an opportunity for [the pharma industry],” Farrar said.
But he acknowledged that the shifting commissioning landscape would require some navigation. “There are challenges to you in engaging with us because the deckchairs are moving,” he said.
Farrar insisted that pharma would be able to engage with newly-formed clinical commissioning groups (CCGs) and the new Academic Health Science Networks being set up by the DH to encourage ‘cross-border’ co-operation in healthcare.
“This relies heavily on us putting together risk share deals where new products have commercial benefits for [pharma],” he admitted, while expressing sadness that the process was not moving faster.
“It’s taking so long,” he said. “We’ve got to learn the lessons about how to connect with the NHS and not just Whitehall. We all have to work harder.”
Ramona Sequeira, MD of Eli Lilly UK, was concerned that the NHS’s overwhelming focus on saving money – the QIPP challenge means £20 billion of efficiency savings have to be made by 2014-15 – might have a disastrous effect on broader healthcare goals.
“One of the things as an industry we find scary is the focus on austerity in the short-term makes you make decisions that might be detrimental in the long-term,” she said.
“Trying to procure medicines in the way you would [procure] tape or chairs is dangerous. The clinician needs to make the best decision in the interests of the patient,” Sequeira added.
The nascent NHS Commissioning Board will have a key role here, and its director of partnerships Ivan Ellul mentioned a few areas where it would need help from pharma.
One of these is in improving patient outcomes. In a statement that will be music to the ears of pharma, he said: “We recognise that we will have to spend more money on certain drugs. We’re really up for a discussion with [pharma] about how we can improve early access to medicines.”
And on research and innovation, Ellul said, the Board was ‘serious’ about partnership with the pharma sector. “But there’s no financial headroom,” he warned, explaining there was a need to structure deals which give pharma “a foot in the NHS market” while enabling the NHS to operate with 0% growth.
Kate Caston, the Board’s head of specialised commissioning, wants pharma companies to provide more information on drugs – particularly orphan drugs – before they are marketed.
Asked whether pharma would see less spending on generics under the new arrangements, she said: “It comes back to evidence-based commissioning, so we shouldn’t necessarily be commissioning the cheapest.”
For details on attending our conference ‘CCGs, the new NHS and Pharma’ on 5 December in London, click here.
Adam Hill
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