The Association of the British Pharmaceutical Industry (ABPI) Cymru Wales, recently commissioned the Office of Health Economics (OHE) to provide a view of the past, current and likely future use of medicines in Wales. The results are published today, in the report: Health and the use of medicines in primary care in Wales.
The ABPI commissioned this report to look at comparative trends and patterns in the use of medicines in Wales compared to other nations within the UK, and inform the debate as to the optimal use of medicines.
The report confirms the trend for Wales to have a high volume, low cost approach to medicines and notes the reducing percentage of the health budget spent on medicines. It also highlights some concerns and future dangers. A snapshot view of the use of NICE approved medicines suggests that such guidance is not implemented as fully in Wales as in England, whilst the growing population of over 65s suffering from long term conditions re-enforces the need to fully utilise the benefits of clinical and cost effective medicines.
The report highlights a trend – and several examples – where patients in Wales do not reach comparative health outcome targets. It also suggests that most Health Boards are not fully utilising the medicines budget allocated by the Welsh Government with an under-spend of over £70 million in 2009–10. This probably explains why Wales also has the lowest growth in expenditure on medicines, over recent years, amongst the countries of the UK. During a similar timeline the report also suggests a relatively low use of medicines recommended without restriction by NICE, when compared to England.
Forecasts in the report estimate future use of medicines in Wales and highlight that over the next few years, as several high use medicines are losing their patent protection, savings of a further £180 million will be made from the Wales prescribing budget.
Richard Greville, Director of ABPI Cymru Wales, explains:
“Despite increasing demands, NHS Wales appears to have been very successful in managing the medicines budget over recent years, however some worrying trends are appearing. The relatively poor implementation of some medicines recommended as clinically and cost effective by NICE, and examples of where patients do not achieve the health outcomes seen in England or Scotland seems to suggest a need to revisit the approach to the use of medicines in Wales.
"Now is the time to acknowledge and recognise that the incremental benefits of innovative medicines, such as reduced side effects or improved compliance or simplified routes of administration can improve health outcomes.
"Like every part of the NHS budget, the use of medicines should be considered carefully and as a result of full and open dialogues between clinicians, patients, the pharmaceutical industry and those with budget responsibility. The value of medicines should not be evaluated only in terms of acquisition costs or without reference to the evidence base and costs attributable to alternative health service provision. Medicines, especially those recommended by AWMSG or NICE can also reduce demand on NHS resources by reducing waste or allowing provision of care in the community closer to home, rather than in a hospital setting. On the other hand, indiscriminate cost containment measures for medicines could inadvertently have a negative impact on waste, patient compliance and longer term improvements in health outcomes in Wales.
"Efficient and effective patient care pathways take a holistic approach to deliver patient outcomes and medicines should be viewed as a critical component of that solution. I hope that the Welsh Government, NHS Wales and the pharmaceutical industry can work together to develop patient pathways that deliver the best outcomes for patients”
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About the ABPI
We represent innovative research-based biopharmaceutical companies, both large 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. Our members supply 90 per cent of all medicines used by the NHS, and are researching and developing 90 per cent of the current medicines pipeline, ensuring that the UK remains at the forefront of helping patients prevent and overcome diseases.
We are the Government recognised body negotiating the pricing of branded medicines on behalf of the entire industry. Working with our Research Affiliate Members, we promote the UK as a destination of choice for international life sciences investment.