My first 100 days as CEO of the ABPI have passed. In this time I have observed our organisation and our industry - and I have tried to do this with the mind-set of an outsider looking in.
So what was the purpose of this?
My intention was to study and assess where we are, what we are doing right, and where we can improve. Now that I’ve had the time to reflect I would like to take this opportunity to discuss how we can – and must – evolve.
Firstly, the ABPI needs to become more than the industry’s trade body; we must be the voice of our industry. We need to be prepared to say what others cannot. And by working closely with all of our members – large, medium and small – we can and will lead the way.
Over the past 20 years our industry has fundamentally changed. Before 1990 there was an arms race; during this first era the priority was the discovery and sale of blockbuster medicines like statins, ACE inhibitors and antibiotics.
However, two decades ago, as cost constraints kicked in and enforced price cuts were pushed through, the second era started. The mechanisms had changed and our industry needed a new direction. We have now found that new direction, and the third era is starting: the ‘Prove it works’ era.
For a number of years, the industry has worked in partnership with parts of the NHS to help redesign pathways. We have moved beyond purchaser and seller transactional relationships; this next era will be based on partnerships and collaboration. And by using real world data we can, for the first time, provide evidence of value – we can prove it works.
To get the best possible value from medicines it is critical that the Industry and the NHS have a seamless relationship. The NHS will need to track data after a medicine has been launched - research which has always started at the bench will now continue through to the patient’s personal medication. This real world data is the subject of the report we launch here today: ‘The Vision for Real World Data – Harnessing the Opportunities in the UK’.
The collection and use of Real World data will allow us to demonstrate the true value of treatments – but for this to happen, we need to increase the uptake of innovative new medicines. The UK lags behind in terms of patient access and uptake and this needs to change. If we are to benefit from better health outcomes then UK patients need to be given faster access to treatments – for example, in the UK the use of new cancer medicines is 33% lower than the European average1.
Besides the obvious advantages to industry, the collection and use of real world data will potentially lead to a better understanding of conditions and treatments in a wider population. This will deliver benefits such as patients suffering fewer side effects, better management of chronic conditions and the avoidance of preventable hospitalisations.
Real World data will provide us with the means for assessing the true value of a medicine – it will provide us with the opportunity to improve patient quality of life while reducing NHS costs. There are wider economic advantages too, as Real World data studies will encourage investment by the pharmaceutical industry in the UK – the wider plan for growth is of course already creating a positive environment for research – but to make the best possible use of Real World data we must have seamless collaboration between the NHS and the industry. This overlap will lead to a greater transfer of skills and sharing of knowledge and expertise. This can only work to the benefit of the NHS, the industry – and, most importantly; patients.
So there are many positives.
But, before we progress, we must examine our legacy. We must accept that the perception of industry needs to be addressed. Reputation challenges will only cause problems to working partnerships – to the detriment of patient health.
We need to show that the industry is part of the solution, not the problem. We have done an immeasurable amount of good over the years – many of our friends and family are alive now only because of this industry. And in this time of financial constraint our role is more crucial than ever before – in the UK 72,000 jobs depend on the industry, and the latest figures indicate that we lead the way in research and development with nearly four and a half billion pound invested here each year2. And our patient access schemes are vital to both the NHS and the patients they benefit. But we need support. And we must work with the Government to ensure that VBP, or any other new scheme, does not become the fifth hurdle. We need the freedom to modulate – and, crucially, we need the freedom to innovate:
Developing innovative medicines is a complex, and expensive process that remains full of uncertainty, but the risks are worthwhile taking - innovation has brought us life-changing medicines. Thanks to incremental innovation AIDS is no longer a death sentence. Statins, too, have saved thousands of lives, and without a pharmaceutical treatment for Alzheimer’s the cost to the NHS will cripple the system. In each of these cases improvements to patient health and quality of life is paired, or will be paired, with significant savings to the NHS. These are just three examples among many, but in order to maximise these benefits we need to see greater engagement in the research agenda from some areas of the NHS.
We also know that the UK is leading the way in the use of generic medicine - our market is highly efficient and cost effective - and between 2009 and 2015 the NHS will save more than £3bn3 thanks to products coming off patent. If we invest this money into innovation, it will help us develop new, necessary medicines, while saving the NHS money in the long run.
I believe that those who work in our industry do so to help improve patients’ quality of life and ease suffering – much like doctors and nurses in the NHS. Improvements in speed, quality and delivery in clinical trials are already evident. Early research has been strengthened by the formation of the translational research partnerships, but continued collaboration and delivery is crucial. We want to continue to develop and deliver life-saving and life-changing medicines, and if we change the perception of our industry we will enable our members to build partnerships with the NHS for the benefit of patients and the economy. We need to ensure the UK remains as a global leader in clinical research for the benefit of the healthcare economy.
The nature of healthcare provision has changed. The reliance on pharma is bigger than ever. The effective use of medicines is the only answer, and to make this work, our joint working partnerships must be seamless - we need to make sure we are all going in the same direction. The NHS, the Department of Health and the Industry all recognise the need for partnership, and this openness to joint working puts us in a strong starting position. But how does the industry make this work? That is our challenge. And that is where the ABPI must take the lead.