A new social contract between pharma, the NHS and patients will need to be forged if the industry wants the UK to strengthen its market access policies.
This is according to a letter, seen by PMLiVE via a Freedom of Information (FOI) request, which outlines the creation of a new group to assess how the public and the NHS feel about the risk and value of new drugs.
The letter comes from Professor Sir John Bell (pictured) and Professor Sir John Tooke, the co-chairs of CASMI – the Centre for the Advancement of Sustainable Medical Innovation – a partnership between Oxford University and UCL.
In the letter, originally sent in March, the co-chairs wrote that there needs to be a “much deeper understanding of the perception of risk and value, at the individual, system and societal level that impinges on the update on medical innovation”.
To this end, a new body called the Medical Innovation Academic Consortium (MIAC) has been established, and will be run by Professor Rob Horne as a separate arm of CASMI.
This body will call from experts in law, ethics, economics, behavioural science and other disciplines, to help: “Create a new framework for a social contract and clear research agenda” from the life sciences industry.
The group will also publish a series of papers based on its research to explore the key issues for the main stakeholders who receive the benefits of medical innovation.
This will be run alongside an ongoing governmental review into medical innovation and the need to speed up market access in the UK, which is currently being run by life sciences minister George Freeman.
It also comes 18 months after a new, five-year drug pricing scheme between the government and the industry was established, which has seen pharma pay ‘rebates’ back to the NHS when it has gone over an agreed upon limit on how much revenue it can generate in the country.
The PPRS scheme, as it is known, was also meant to bring in a swathe of changes to how a drug’s value was assessed – but this element of the scheme was dropped, leaving the question over just how much should be paid for new innovations left wide open.
A cultural shift?
The value question, however, has only become more pertinent, and these reviews come at a time when the price of new drugs are becoming increasingly high and putting extra strain on payers and healthcare systems.
There has in the past 18 months been an attempt to reform certain elements within NICE – the Institute responsible for assessing the cost-effectiveness of new treatments that are paid for by the NHS in England – but any potential changes have been indefinitely delayed after the body failed to reach any firm conclusions on what processes should be changed.
The MIAC’s work, which will be ongoing until spring 2016, goes much further than the government’s review, which is geared more toward helping pharma get its medicines into the NHS more quickly.
As MIAC is proposing a broader assessment of what medical innovation means to patients and the NHS, the results may not be comfortable reading for pharma, as criticism over highly expensive drugs has become much louder in recent years.
Professor Sir John Bell, who has prompted the review, is also known for being critical of the industry’s price tags for new treatment, and said in a recent paper on the topic: “It’s very difficult to see how we can continue the same paradigm of healthcare with its dramatically rising costs and the relatively inefficient application of costly new therapies across large populations when they give only modest benefits.”