Guest article from NHS England: New funding approaches to drive adoption of innovative medicines pilot

In this guest article from NHS England, David Glover, Assistant Director in Medicines Value & Access at NHSE, provides an update on a two-year pilot, due to start next financial year, to test whether removing local affordability barriers speeds up and evens out uptake of NICE-approved medicines for Chronic obstructive pulmonary disease (COPD), chronic kidney disease and heart failure, with the evidence used to shape future policy.

The UK has enviable strengths in life sciences, including in academia, clinical trials and personalised medicines, with a target to be Europe’s leading life sciences economy this decade, and by 2035 rank alongside the US and China.

For the UK to achieve its international ambitions for life sciences, with all the economic benefits that could bring, like new investment, good jobs and growth across the country, we must continue to address the gap between approval of innovative treatments, and their routine adoption in NHS clinical practice.

The implementation of the US-UK Pharmaceuticals Arrangement has already improved the commercial medicines environment and led to life-changing treatments becoming available to NHS patients in England that would otherwise have been out of reach.

For the UK to increase its role as a global hub for life sciences, patients across the country must be able to access more innovative treatments in a fast, fair and consistent way.

The development of a Single National Formulary (SNF) will be a key part of the approach addressing inequity of uptake of NICE approved innovation arising from varying local formulary arrangements.

But even with the formulary ‘green light’, we know that local affordability can influence pace and scale of implementation, particularly for medicines commissioned by Integrated Care Boards (ICBs) that can often be for larger eligible populations.

A partnership focused on practical solutions

Over recent months, stakeholders from across the health and life sciences ecosystem have come together through a Joint ‘Sprint’ Taskforce to identify practical ideas to improve the adoption of innovative medicines. Bringing together representatives from industry, the NHS, Government, NICE and patient organisations, the group has explored where barriers exist and how they can be overcome.

This collaborative work has resulted in a series of pilots designed to support patient access to, and uptake of new medicines, while generating valuable evidence to inform future policy development. Central to these proposals is the recognition that improving access and adoption requires action across multiple parts of the system, from funding arrangements and implementation support through to system readiness and accountability.

Addressing one of the key barriers: affordability

One of the pilots being led by NHS England, will explore whether alternative funding approaches can help address how local affordability can negatively affect uptake of innovative medicines and lead to unwarranted variation.

While NICE guidance provides a single, national recommendation for patient access, the pace of implementation from place to place can vary. Financial pressures across local health systems can affect the speed at which innovation is adopted, even where there are strong clinical rationale and alignment to national strategy.

This pilot will test whether reducing or removing this affordability barrier can contribute to faster, fairer medicines uptake among for those people who are eligible. The pilot will generate evidence about how different funding arrangements influence adoption, unwarranted variation and patient outcomes, that can inform policy development.

Focusing on areas where innovation can make the greatest difference

The medicines selected for the pilot have been chosen by NHS England through a structured assessment process that considered factors including unmet clinical need, alignment with NHS priorities, potential for increased uptake and the ability to generate meaningful learning that can be practically applied.

The initial focus includes innovative treatments for chronic obstructive pulmonary disease (COPD), chronic kidney disease, and heart failure. These are conditions that affect large numbers of patients and place a significant burden on individuals, the healthcare system, and wider public services.

By concentrating on therapeutic areas where there is clear opportunity to improve outcomes at scale, the pilot will provide a route to evaluate whether addressing funding barriers translates into meaningful benefits for NHS patients.

What to expect next

The 6-8 week call for participation to NHS Regions will start this Autumn with planned selection before the end of 2026. The target to go-live is the start of the next financial year, to then run for two years. Regions will coordinate ICB involvement, providing oversight and accountability through the pilot process and evaluation.

Importantly, the pilot is designed as a learning opportunity. Success will not be defined solely by increased statistics on uptake, but by the quality of the evidence generated and the insights it provides for future policy development.

Participating NHS Regions will be monitored by NHS England at a national level throughout the pilot, with data collected on use of innovative medicines and associated impacts.

Improving the adoption of innovative medicines is a challenge that no single organisation can solve alone. It requires sustained collaboration within and outside the boundaries of the NHS, working with partners including the ABPI and its members.

As implementation planning progresses, continued partnership working will be essential. By working together to understand and address the barriers to adoption, the UK has an opportunity to strengthen both patient access to the latest and greatest treatments, and its position as a leading destination for life sciences innovation, invention, and investment.