Pulling together

These are testing times for a UK pharma and life science sector whose watchword increasingly seems to be ‘uncertainty’.

Emblematic of this, of course, is Brexit, the fallout from which is top of the agenda for most UK and European pharmaceutical companies. But alongside the UK’s exit from the European Union, the sector faces several other significant issues. Responding to these at the end of August saw Sir John Bell publish his ambitious Life Sciences Industrial Strategy report, which offers a wide-ranging plan for making the UK a world leader in the life science sector.

Looking to tease out some clarity from these tangled trends, QuintilesIMS recently held a high-level industry debate at its London office that attracted CEOs, general managers and directors from pharma, the NHS and patient organisations.

Brexiting

Outlining pharma’s response to the UK’s decision to leave the European Union, ABPI chief executive Mike Thompson told the meeting how the trade body had immediately assembled “200 of the best brains in industry” for different works streams that all ultimately sought to answer the question: How to make the most of Brexit?

“What’s become clear to us about winners and losers across Europe is that either all of the continent of Europe wins or all of it loses. Patients, whether you’re sitting in Germany or France, could be adversely affected if governments are not prepared to coordinate,” he said.

The UK’s scientific strength, Thompson said, will mean Brexit offers less of a prize to countries still inside the EU. “It’s the best cluster in Europe. So there’s a challenge here for Europe - because, quite frankly, if scientists move from Britain they ain’t going to Paris and they’re not going to go to Berlin, they’re going to go to Boston.” For the EU sector to continue to thrive, he added, the whole of Europe should continue to work together.

But with the Brexit negotiations continuing on an adversarial footing, joint working on the region’s common problems is so far in short supply. EU citizens’ rights are a crucial point for the European Union and for UK pharma, whose ability to attract talented researchers and executives to work in the country is so important. It’s a theme that appears in Sir John Bell’s report, where one of its strategic goals is for the UK to attract 2,000 new discovery scientists from around the globe.

Also speaking at the QuintilesIMS’ The Future of Pharma and Life Sciences in the UK debate was Ben Howlett. Now director of Public Policy Projects, he was a member of parliament from 2015 until 2017.

He noted that when it comes to migration the picture is not just one of attracting the highly skilled. “The Home Office has got to understand that if you’re going to build a workforce, in supply chain terms, you need people who are unskilled in order to prop up the skilled workforce.”

For QuintilesIMS’ general manager UK and Ireland, Tim Sheppard, the publication of a life science sector’s strategy that pulls together such a diverse sector is in itself an achievement. “Somebody had to set out an ambitious agenda for improving the environment for clinical trials, improving the access to data for research for our country, so that we have the opportunity to attract and retain companies here, and indeed increase the number of clinical trials and research done here using patient data.”

The real world and data

One aspect of the UK that both the government and industry are keen to talk up is its health service and the opportunity of working with the NHS on real-world studies. The most prominent example of this to date is GlaxoSmithKline’s Salford Lung Study. Launched in 2012 it was the first time a large, prospective real-world study was performed on a pre-licence medicine, across a large population within one geographical setting.

Salford was chosen for the study because it allowed data to be collected from a variety of healthcare services across the Greater Manchester borough, including NHS Salford and the Salford Royal NHS Foundation. “[GSK] had to invest £60m to that local environment to make it work. That’s a huge investment and these things don’t come cheap. But the basic core fundamentals are right in this country and I think there’s a real opportunity,” explained the ABPI’s Thompson.

But there’s still more work to do on easing the way for such large-scale initiatives. Launched in 2014, the Healthy Liverpool programme aims to provide joined-up health and social care services in the city, but when it came to governance, around 3,000 data-sharing contracts were required to get it off the ground.

Responding to this, Chris Carrigan, expert data advisor at user My data, acknowledged “there is some serious work that’s got to be done generally about our social responsibility and how we manage and share data”.

Carrigan, who also chairs an NHS Digital advisory group, said patients themselves don’t want barriers to be in place. “They want sensible safeguards to be there to protect their confidentiality. But it seems to me that patients and patient groups are massively frustrated that we’ve drawn everything too far back around data sharing, fear and being ultra-secure. Because of that you end up with 3,000 data-sharing agreements, which are probably impossible to maintain.”

When it comes to the future of research in the UK QuintilesIMS’ Tim Sheppard said: “Everybody believes that the UK could be a fantastic place to do clinical research, pre- or post-Brexit, but everybody also seems to agree that we’re at a fork in the path, where we could fall off and become a much less significant life science player or we could go the other way and become a really significant global player.”

NICE and pharma

Also high on the agenda at the event was NICE’s approach to appraising new medicines. Defending its work was the Institute’s programme director of technology appraisals, Meindert Boysen, who said: “We’re producing 80% positive recommendations - this is secure access. Many people think we’re the institute of ‘no’, but actually we’re the institute of ‘yes’,” he said.

“The NHS is interested in managing access, not in blocking it,” he said, adding that NICE and pharma were “in the same business”.

Responding to the charge that NICE only exists to present a rationale for the use of resources, he said: “That’s NHS England’s job, it’s not our job at all. Our job is to make sure we buy value. And if that value is increasing, then we need to buy more value.”

Now’s the time

Looking to the future Professor Keith McNeil, NHS chief clinical information officer, operations and information at NHS England, said he was optimistic about pharma and NHS efforts to implement Sir John Bell’s report.

“There’s no question that it is in our gift, as a system, to put this together to form a really good relationship to make sure that patients get what they need, when they need it and we can do that within the cost envelope that is the NHS.

“But we have got to transform so much of what we do and how we do it now - that’s going to be the challenge, but it is absolutely possible.”

The ABPI’s Thompson said: “But the fundamentals of this country are fantastic and Brexit sets us an ‘exam question’: Can we respond to things? In which case I think there’s a fantastic future. If we fail to respond to it we’re going to have some hard times and the Sir John Bell report gives us a blueprint and it requires everybody to pull together.”