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Let's be ambitious for patients and life sciences investment in Global Britain

“Take up of new medicines in the UK continues to be slow by international standards”. Since this Pharmaceutical Industry Competitiveness Task Force report in 2005, there have been at least five UK life science strategies plus three PPRS or VPAS deals. All have promised to accelerate access of new medicines to patients. Sadly, 12 years on, the 2017 Life Sciences Industrial Strategy could only restate the challenge: “Evidence demonstrates that access to and diffusion of products in the NHS is often slower than in some comparable countries”. Can we ever break this cycle? By Andrew Harrison, Group Managing Director of Hanover Health.

The Government’s 2019 election manifesto pledged to make the UK the leading hub for life sciences. Yet with the sector seen as crucial to economic regeneration post-Brexit and post-pandemic, the slower use of innovative medicines in the UK is a drag anchor on the Government’s ambitions. It is repeatedly acknowledged by global industry headquarters to be a negative factor when considering investment location decisions. And whilst the UK still does well for investment, it could do much better.

In post-Brexit ‘Global Britain’, Government wants a rejuvenated MHRA to help the UK become a global early launch market. But the UK also needs an HTA system fit for the future. Companies are unlikely to flock to the UK for an early licence unless there is also early access and use in the NHS.

From the Cancer Drugs Fund to the promised Innovation Drugs Fund, initiatives have been created as technical ‘work-arounds’ for NICE and for an HTA system that has not kept pace with the types of treatments now being developed. These initiatives have enabled some patient access and are welcome, but their very existence highlights the ongoing absence of substantive reform to NICE itself.

The current NICE Methods Review is an opportunity that should be grasped by Government to enhance patient access to new medicines and simultaneously boost the attractiveness of the UK to the life sciences industry.

Global boardrooms that control huge and internationally mobile investment budgets have welcomed the Government’s positive rhetoric towards life sciences. But actions speak louder than words and limited NICE reform will be seen as a conscious act of apathy by the UK Government towards the industry.

One argument against NICE reform is its potential greater impact on NHS budgets.

Industry argues that the remarkable VPAS deal which caps NHS spending on medicines would cover any costs. However, many in NHSE and DHSC argue that the VPAS is not a true financial safety net as reimbursement decisions taken now will have expenditure consequences after the current scheme ends in 2023.

Perhaps it is time to consider a new more ambitious deal which works for Government, patients and industry? A new 10-year VPAS with more substantial and defined NICE reform locked in?

A similar scheme capping NHS medicines spend would give long term (and much needed) certainty and security to NHS finances and a longer time-horizon would remove the Government’s end-of-deal-risk on reimbursement decisions. As well as NICE reform, industry could seek Government commitments to curtail NHS England’s cost-squeezing tenders which create no actual saving to the NHS or taxpayer - because medicine spend is already capped - but which damage UK reputation as anti-innovation in the eyes of global pharma headquarters.

A triple win is on offer. Patients gain faster and fuller access to the latest medicines; the UK is seen as more attractive and innovation-friendly by investing industry headquarters; and the NHS and Treasury gain this without paying a penny more than planned due to capped medicines spend until 2034.

For both Government and industry here is an opportunity to break the cycle of unfilled ambitions on patient access to the latest medicines, and to remove an important barrier to life sciences investment for the new Global Britain.

9th November 2020

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