The ABPI represents innovative research-based biopharmaceutical companies, large, medium and small, leading an exciting new era of biosciences in the UK.
Our industry, a major contributor to the economy of the UK, brings life-saving and life-enhancing medicines to patients. We represent companies who supply more than 80 per cent of all branded medicines used by the NHS and who are researching and developing the majority of the current medicines pipeline, ensuring that the UK remains at the forefront of helping patients prevent and overcome disease.
Globally our industry is researching and developing more than 7,000 new medicines.
The ABPI is recognised by government as the industry body negotiating on behalf of the branded pharmaceutical industry for statutory consultation requirements including the pricing scheme for medicines in the UK.
¹ A ten-fold difference in usage between local area teams is shown with Denosumab, used to treat Osteoporosis. The NICE Implementation Collaborative (NIC) is currently working to overcome barriers to uptake for Denusomab. Some of the key reasons for variation include lack of funding, differences in local interpretation of NICE guidance and insufficient services and pathways to enable patients to access the medicine.
A 29-fold difference in usage between local area teams is shown in the NOACs data within primary care - rivaroxaban and dabigatran (for atrial fibrillation for the prevention of strokes). Local variation in access could be a result of: local medicines protocols or guidelines placing restrictions contrary to NICE guidance on the prescribing of NOACs as a class, despite their inclusion on the formulary or NOACs remaining absent from local formularies completely. This is also confounded by perverse incentives around funding for warfarin clinics and prescriber confidence with services moving from secondary to primary care.
² One in three patients with renal cancer who are eligible for one of two new medicines - sunitinib or pazopanib - to treat the condition, did not receive these medicines due to the area that they live in. This is based on the NICE estimate for uptake of these medicines. A number of factors still hinder the expected uptake of these medicines for patients. The NHS demonstrates varying degrees of a ‘watch and wait’ approach from point of diagnosis to introducing active treatment. Then the varied service provisions to deliver these targeted medicines in renal patients exacerbates this issue further. There is a real need for the wider NHS to learn from those that do it best.
About the report
The report was developed by a joint Department of Health, NICE, pharmaceutical industry and HSCIC working group to measure how well patients are able to access the medicines approved by NICE.
The report contains a new section to measure the variation in the usage of medicines at a local level. It also provides an estimate of use against NICE’s expectation for a small number of medicines.
Variation and barriers to the use of NICE-appraised medicines
It is significant to note that the newer medicines seem to have a higher degree of variation than older medicines. It could be argued that, if new medicine guidance were implemented appropriately and funded within the 90-day timeframe that is legally required, there would be less variation than with some older medicines.
Recognised barriers to the use of NICE-appraised medicines include lack of funding, different interpretation of NICE guidelines and insufficient services and pathways to enable patients to access medicines. It is, however, recognised that there are also a number of legitimate factors which influence variation, for example, local or regional demographic factors which influence health needs and subsequent supply of medicines.