Celebrating its 70th birthday this year, the National Health Service in England is in the throes of another transformation – new models of care, led by Integrated Care Systems are now seen as the way forward towards a sustainable, integrated health and social care service.
But how can the pharma industry engage with these new models of care? Among the key messages is that the industry needs to move beyond one-off pilots which don’t have patient outcomes at their heart, and instead contribute to new, outcomes-based and sustainable systems.
I’ll be chairing Pharma Market Europe and IQVIA’s roundtable next week tackling this central question:
New Models of NHS care – New Models of Pharma Response?
Ahead of the meeting, I caught up with one of our industry speakers, Fiona Bride, head of UK market access strategy at Novartis.
Fiona has many years of experience in dealing with the NHS, and Novartis has a broad portfolio across therapy areas, as well as a proactive approach to exploring novel pricing and reimbursement deals. Nevertheless, arriving at genuine ‘win win win’ deals – with the third ‘win’ being for the patients – is still not easy to achieve.
Fiona Bride
“We really recognise the need to look through the lens of the NHS when trying to understand how innovative medicines can benefit patients in the UK,” says Fiona.
“That’s easy to say, of course – the reality involves the industry taking the time to understand the granular challenges facing the NHS, and how patient population are being managed in the health and care system as a whole.”
Fiona says that once they reach that level of understanding, companies can take a much broader view of a disease or population pathway, and can then properly consider how an innovative medicine can add value to the system and to patients.
“What I’ve learnt is that what works well is co-creating a solution with the NHS – and not having a “here’s one we made earlier” approach.”
She says that even the most simple pathway mapping exercise needs to be informed by knowledge of nuances in the local health economy.
Even with the drive towards Integrated Cares Systems (ICSs) across England, the reality is that the industry will still have to deal with multiple, independent NHS organisations when negotiating a joint working initiative or collaboration.
Greater Manchester is a trailblazer for integrated care in England
She says Greater Manchester’s Health and Social Care Partnership, which covers 2.8m people in the north west of England, has great potential, and is a trailblazer for ambitious integration initiatives.
Fiona also praises smaller regional integrated care programmes, such as Frimley Health and Care, an emerging integrated care system in Surrey (home to Novartis’ UK head office) which covers a population of around 800,000.
An Outcomes Guarantee model – Cosentyx promise
Among the many initiatives Novartis is working on with the NHS is ‘The Cosentyx Promise’. This is of particular interest because it was devised specifically for the UK market.
Cosentyx is the company’s psoriasis treatment, and Novartis supplies the drug with an outcomes guarantee. This states that if patients don’t see adequate improvements, the NHS is compensated.
“It comes back to what is our shared goal: focusing on patient outcomes rather than focusing simply on uptake of innovative medicines,” says Fiona. “You need to have strong data to support that commitment, but you also have to recognise that we have a responsibility to support the NHS’s drive for best value in medicines.”
Novartis now has 26 separate agreements across England on the Cosentyx Promise – a sign of success, but also an indication that each locality requires its own agreement, demanding that relationships and trust are painstakingly built in each region.
Fiona is optimistic about the ability of the NHS and pharma to move beyond the pitfalls of perpetually running pilots (“the NHS has more pilots than British Airways,” as some wags would have it), with both sides needing to stay focused on long-term, transformational goals.
“The Academic Health Science Networks (AHSNs), which are now more focused on translating and scaling up these interesting local initiatives and innovations have the potential to further accelerate impactful programmes,” she adds.
Hear more from Fiona and her fellow panellists at the PME and IQVIA roundtable event on Tuesday 30 October in London – free to attend for pharma industry and NHS employees.
Update: Ewan Barbour, Market Access and Pricing Director at Merck will also be speaking at the event. The company has just secured ‘Rapid Uptake’ status for its multiple sclerosis drug Mavenclad via the new Accelerated Access Collaborative process.