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The NHS 'needs you'

Joint Working is a clear indication of the desire for an open and honest relationship

A doctor pointing straight aheadIf you have a discussion with anyone in the pharma or business intelligence industry about market access everyone agrees that having a market access strategy is critically important for the business. After all, if you can't bring your product to market, where are you? This is reinforced by high-profile rejections by NICE particularly in the area of oncology. The environment for pricing and reimbursement is increasingly challenging, thanks to the recession and uncertainty about how the UK is going to pay back its huge deficit. This is likely to include cuts or 'rationalisations' somewhere in the health system.

'Betrayal of 20,000 cancer patients' screams the Daily Mail (March 16, 2010) and 'up to 20,000 people die needlessly' as NICE rejects another new drug for a rare form of cancer. The coalition government has announced that NICE will face reform, and there will be a move to more 'value-based' pricing so that all patients can access the drugs and treatments their doctors think they need.

But what does this mean? Does this mean that the NICE approval process is going to be axed? How will GP practice-based commissioning, free from the constraints of SHAs and PCTs, be able to make judgements on the ethics of a new drug or set of services? How will health budgets be kept under control? Or will the old SHAs and PCTs morph into GP consortiums – changing the name, but not the personnel for decision making?

There is a distinct lack of clarity about who you really should be communicating and engaging with. Market access is about communicating the positive impact of the product on the wider healthcare market (ie, patients), and this needs to be packaged for the right audience in the right way.

There is a broad array of stakeholders taking part in an approval decision, from payer and government organisations through to clinical and economic KOLs and patient advocacy groups. Who knows if this may broaden out further still as our current government's health strategy is slowly revealed, or whether it will be the same people under different umbrella organisations. Effective communication, and by this is meant 'communicating in the language of the intended recipient', is one of the biggest challenges.

The one phrase that has been consistent throughout these changes is 'improving patient care'. The landscape in which the NHS operates is defined by the Quality, Innovation, Productivity and Prevention (QIPP) agenda: this is not an isolated, independent NHS, it is one that has to take into account the views of local people, patient advocacy groups and the patients it seeks to look after.

The general public has real affection for the NHS, and the vast majority of people are deeply supportive of the original principle of the health service – free healthcare to all, based on need, not income. The NHS is part of the British way of life. The majority of the public expect the NHS to provide drugs 'no matter what they cost' and they have little concern about value for money. It would be a very brave (or foolish?) government that went against these principles.

Where can you make a difference in this sea of uncertainty? The Joint Working agenda for starters indicates a cultural shift towards more collaborative working between the NHS and industry. This is a clear indication of a desire for an open and honest relationship between organisations with different skills sets willing to work together for the benefit of the patient, rather than just have a buyer/seller relationship.

Understanding and assessing how you engage with decision makers in a broader relationship beyond the traditional procurement discussions, to new service models, will build your relationship and reputation beyond that of a drugs company. It will also put you in a stronger position when those discussions have to take place. The NHS is in a very difficult situation, no-one can tell where it will end up in five years time, or who will be driving the decision making. Collaboration and a shared agenda are key to strengthening the relationships you have – being there to support an organisation as it makes difficult decisions on its future.

Sarah Phillips
The Author

Sarah Phillips is head of health at Ipsos MORI
She can be contacted at

This article was first published in PME July/August 2010 as part of the Thought Leader series.

To comment on this article, email



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30th July 2010


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