The NHS Commissioning Board (NCB) has appointed four PCT and SHA bosses as new regional directors.

They will form part of the senior leadership team of the Operations Directorate and will provide guidance for the NCB across their selected regions.

The appointments are as follows:

• North of England – Richard Barker, currently the Chief Operating Officer, NHS North of England and a former Director of Commissioning Development for the North East SHA
• Midlands and the East – Dr Paul Watson, currently Chief Executive, NHS Suffolk, and a former Director of Commissioning at the East of England SHA
• London – Dr Anne Rainsberry, current Chief Executive, NHS North West London and Deputy Chief Executive, NHS London
• South of England – Andrea Young, presently the Chief Operating Officer / Deputy Chief Executive, NHS South of England, and formerly Chief Executive of Oxfordshire PCT.

Ian Dalton, Chief Operating Officer of the NHS Commissioning Board Authority, said he was delighted to have four “highly skilled” directors “each with a strong track record of achievements”.

“This equips us with outstanding leadership to work with clinical commissioning groups and partners to ensure we have a strong and innovative commissioning system that improves outcomes for patients,” he said. “It also enables us to finalise the design of the regional and local presence of the NHS Commissioning Board.”

Their first tasks will be to work with PCTs, SHAs and other stakeholders to design plans for the final model of the Board’s network of local teams.

The appointments follow last week’s NCB announcement of the first wave of applications for CCG authorisation.

The Association of the British Pharmaceutical Industry (ABPI) and the BioIndustry Association (BIA) have revealed plans to move into joint offices in London later this month.

The organisations feel the move demonstrates a more “collaborative era” for life sciences in the UK, though they will still remain independent trade bodies.

The ABPI said the new arrangement builds on its agenda for change set out a year ago by strengthening its capacity to engage with and on behalf of key partners.

Dr Richard Barker, Director General of the ABPI (pictured), added: “Since the establishment of the Office of Life Sciences, our two organisations have been working more collaboratively, and we are already seeing the benefits. Feedback from Government and other key stakeholders following the creation of LifeSciencesUK was very positive.

“Our organisations have been able to operate more strategically, and more effectively, by representing the life sciences sector with one voice, alongside the ABHI and BIVDA. This move strengthens a joint determination that the UK remain a great place to invest and do business in life sciences.”

According to the BIA, the move represents an opportunity to enhance the UK’s competitive position in life sciences, expand collaborative relationships for its members and extend the UK bioscience community.

Nigel Gaymond, Chief Executive of the BIA, commented: “Establishing a central venue where those with an interest in life sciences can access the combined expertise of the BIA and ABPI will enable us to highlight more effectively all that the UK has to offer.”

Stephen Whitehead will be replacing Richard Barker as the ABPI’s Chief Executive from June this year.

ABPI President Simon Jose expressed his “delight” at the appointment. He said: “As chief executive, Stephen brings skills and experiences that will enable us to meet the challenges ahead with energy and creativity.

“His expertise in effective stakeholder relations acquired over a 25 year career in policy, public affairs and communications will provide effective leadership to ensure we work in partnerships that benefit patients, the NHS and the pharmaceutical industry.”

Stephen’s has most recently held senior leadership roles at Prudential, Barclays and Allied Domecq, but previously worked in pharma for ten years at GSK and Eli Lilly.

He said: “In today’s changing environment and demanding economic circumstances it will be essential to work collaboratively and flexibly to realise the value of medicines in contributing to patients’ well-being and to promote the vital importance of this industry in the UK, a traditional home of discovery, innovation and research and development.”

It’s been more than 50 years since the government agreed a pricing scheme for medicines on the NHS. Pf reports on how the transformation to a value-based system will work.

The Government has outlined its plans for value-based pricing (VBP) which will be introduced when the current PPRS agreement expires at the end of 2013.

A new value-based approach to the pricing of branded medicines was issued for consultation in mid-December explaining why the Government has decided to overhaul the way that medicines are paid for by the NHS.

In the report Health Secretary Andrew Lansley says the current scheme “does not promote innovation” and has often seen the NHS “pay high prices that are not always justified by the benefits of a new medicine”.

Since 1957 the Pharmaceutical Price Regulation Scheme (PPRS) has been used by governments and the pharmaceutical industry to agree a fair price for medicines, and a fair return for pharma to enable it to research, develop and market new and improved medicines.

However, with the NHS aiming to make £20 billion of efficiency savings the report says value-based pricing is now seen as a way to “provide NHS patients with better access to effective and innovative medicines at a price that secures value for the NHS”.

The DH states that the new system needs to address a number of important objectives. VBP must strike a balance between delivering affordable prices and providing pharma with an incentive for innovation. Although this rhetoric is similar to the existing PPRS, the report says that currently there is no encouragement for innovation in the areas of greatest unmet needs.

Therefore, VBP aims to address a broader set of objectives including improving outcomes for patients through better access to effective medicines, stimulating innovation and ensuring value for money and the best use of NHS resources.

Under the new system the Government is to set introduce a range of thresholds or maximum prices that reflect the different values medicines offer. The ‘value’ of a product will then be assessed and its benefits compared against other benefits that could be gained if the funds were used to help patients in other areas of the NHS. One way of measuring this would be to use Quality Adjusted Life Years (QALYs) as NICE currently does in its technology appraisals – although the report stresses this is not the only option.

In the existing price scheme a standard threshold is applied to all new drugs. Although a certain amount of flexibility can be added for additional relevant factors, the report says the mechanism for taking wider factors into account is not “completely transparent”. But under the new system the Government would be able to apply four different price thresholds which could be adjusted to reflect a broader range of relevant factors to calculate the full value of a new product.

The thresholds include a basic option, then a higher threshold for medicines that tackle diseases where there is greater “burden of illness”. The threshold increases again for medicines that can demonstrate greater therapeutic innovation and improvements and finally a threshold that demonstrates wider societal benefits.

The Government says that by designing and implementing the new “stable and transparent” system it will allow pharma to predict in advance how products may fare and give them greater certainty when making long term investment decisions.

Industry response:

“We welcome the publication of the Government’s consultation on value-based pricing and look forward to representing the pharmaceutical industry in co-creating the new system with Government,” said Dr Richard Barker, Director General of the Association of the British Pharmaceutical Industry.

“As Government has said, the priority in any new system must be rapid and consistent patient access to new medicines - value is meaningless without consistent access. Any new system must also fairly recognise and reward innovation and investment in research and development. The UK continues to lag behind Europe in the uptake of innovative medicines despite having amongst the lowest prices, so price alone is clearly not the main driver of access in the NHS. But we agree fully that the Government and the NHS should seek value for money from medicines, and expect NICE to continue to play a key part in the process. Our industry must demonstrate the full value of its medicines, it is for Government to put in place processes which assess that full value, and then secure access to that value for NHS patients.”

The ABPI has backed the Department of Health’s guidance to tackle medicine shortage supply in the UK.

Best Practice for Ensuring the Efficient Supply and Distribution of Medicines to Patients advises that pharmacists and drug wholesalers should keep regular communications and that pharmacists should receive orders within 24 hours.

Dr Richard Barker, Director General, ABPI, welcomed the publication but said “stronger action” was needed from the Government to “tackle the root causes of this problem”.

There are currently 1800 Wholesale Dealer Licences granted in the UK, the second highest in Europe.

The Medicines and Healthcare products Regulatory Agency (MHRA) consulted on proposals to tighten regulation on licences last year. The ABPI agreed with the MHRA that medicines are not ordinary items of commerce, and should only be traded by properly qualified and professional organisations.

“The ABPI has consistently called for the number of wholesaler dealer licences in the UK to be reduced to enable better regulation by the MHRA and wants to see stricter obligations on all in the supply chain to ensure UK patients are always the priority,” said Dr Barker.

The ABPI and BIA have backed the UK as a home for research and development (R&D) after Pfizer decided to close its facility in Sandwich.

The BIA insists Pfizer’s decision is not a reflection on the UK and that a number of the top universities, financial centres and world class research charities are still present.

Nigel Gaymond, Chief Executive, BIA, says that the Association is working closely with the Government to create “the best possible environment for small bioscience companies to flourish”.

My Gaymond also believes that recent initiatives such as the commitment to technology and innovation centres, the patent box, and the Office for Life Sciences will strengthen the UK’s position as a preferred location for manufacturing and R&D.

“The UK remains the second home next to the US for the pharmaceutical and biotech industry and indeed Pfizer’s commitment to their Cambridge, UK site – where they have announced there will be a new Pain and Sensory Disorders Unit – as their global hub in Europe demonstrates this,” said the Chief Executive.

Dr Richard Barker, Director General, ABPI, echoed Mr Gaymond’s comments, insisting that “the UK bioscience environment is world class” and it too is working closely with the Government “to capitalise on these assets in what is still the UK’s leading science-based industry”.

Patient access to NICE approved drugs varies across the Primary Care Trust (PCT) level, a new report shows.

The Use of NICE-appraised medicines in the NHS in England - 2009, Experimental statistics highlights stark regional variations on the uptake of approved diabetes and osteoporosis drugs.

Dr Richard Barker, Director General, ABPI, says that, although the report is still in progress, it “raises some serious questions for healthcare providers”.

The data, published by the NHS Information Centre, is the work of the Metrics Working Group and compares predicted and observed use of 47 NICE-approved medicines in the NHS across England.

The report focused on new medicines in 18 groups, relating to 29 technology appraisals.

Data showed how usage of insulins to treat diabetes varies from 65% less than predicted by NICE to 95% higher than expected in different regions. The variation is even greater when comparing six osteoporosis treatments recommended by NICE, with the lowest usage being 79% below expectation levels and the highest 632% higher than expected.

“What is clear from this data is that you need to look at a local level to see what medicines patients are really getting access to,” said Dr Barker. “With some of the medicines at national or SHA level usage data looks fine but the picture looks quite different at the PCT level.”

“Recent reports repeatedly show the UK continues to lag behind other western European countries in the uptake of most innovative medicines despite having among the lowest prices. So price is obviously not the only factor in patient uptake: we need to understand the other factors that influence what patients receive.”

The report, the second from the Group, is still experimental but shows progress has been made in highlighting regional access to recommended medicines since the first report last year. The data collection was agreed as part of the 2009 Pharmaceutical Pricing Regulation Scheme and provides an insight into what is happening so that healthcare providers, industry, patient groups and the Government can look more closely at why and where variation is happening and work together to develop solutions.

The ABPI says the Government’s Cancer Drugs Fund (CDF) offers a real opportunity to reverse the trend of the UK lagging behind European countries in cancer treatment.

The £600m fund will provide patients greater access to drugs recommended by their doctor through a £200m allocation each year until 2013.

ABPI Director General Dr Richard Barker says the additional funding “provides a unique opportunity to improve patient access to cancer medicines” but warned of regional disparity unless the right mechanisms are introduced.

The Association has called for “close and transparent monitoring” of how the fund operates, insisting that money alone will not provide a sustainable solution. It says that in some areas the interim CDF has improved patient access and decision-making consistency, but has suggested a number of key recommendations to avoid a lack of regional inconsistency, including:

· a national framework from the DH including a clear criteria so that cancer medicines which should be paid for from the CDF can be quickly and easily identified;

· detailed guidance to the NHS to ensure consistency in the implementation of the CDF across England and to minimise potential inequities and variability in access to cancer medicines;

· patient representatives on local decision making panels and broader patient involvement in the CDF at a national level;

· quarterly reports on how the Fund is operating to assess efficiency in meeting the needs of patients locally; and

· enabling monies to be transferred between NHS regions where a clear over or under spend  is identified and for funds to be carried over from one financial year to the next if any surpluses remain.

“The ABPI and industry welcome the Cancer Drugs Fund as an important step forward in helping patients, but money alone cannot solve the complex issue of increasing access to cancer medicines in line with estimated patient needs,” Dr Barker said.

“We need a clearer picture of what is happening on the ground so that sustainable solutions can be found and the UK leads rather than lags behind other countries in patient access to cancer medicines and survival rates.”

He also stressed that it should be clear that the CDF is an addition to the current system, it does not replace NICE’s appraisal process, and that for patients to benefit, treatments must continue to be approved by the Institute.

Alongside the recommendations, the ABPI also advises that cancer medicines and specific indications for sub-groups of patients which have not been reviewed by NICE or have received a negative recommendation by NICE, and medicines and special indications which are being appraised by NICE, should also be eligible for funding by the CDF.

A new initiative has been launched by the UK’s four key healthcare trade associations to build on the Government’s commitment to life sciences.

LifeSciencesUK has been formed by the Association of British Healthcare Industries (ABHI), the Association of the British Pharmaceutical Industry (ABPI), the BioIndustry Association (BIA) and the British In Vitro Diagnostics Association (BIVDA) with the aim to strengthen the sector.

Lord Howe, Health Minister (pictured), says the “exciting initiative” will “allow the industries to work closely in helping the NHS provide quality care and improve productivity with new technologies”.

Key objectives for the enterprise include a drive to improve the investment for UK companies, improve access to new medicines, devices, technologies and diagnostics, and demonstrate the importance of the life science sector to the UK economy. It also aims to provide a strong, unified voice to the Government, providing better collaboration across industry departments, academia, patient groups, the media and other stakeholders.

Richard Barker, Director General of the ABPI, said: “Global competition in life sciences is mounting, so we need to ensure the UK’s comparative advantage remains high. By working together, our united force will strive to ensure patients have access to the new medicines and technologies they need. We want the UK to be the number one destination for international life sciences investment.”

He added that the sector is a “jewel” in the UK’s economy and will be vital for the UK to get “back on its feet”.

Mr Barker’s claims were backed by the Government’s R&D Scoreboard which showed that the pharmaceuticals and biotechnology sector continued to be the largest contributor to R&D in the UK in 2009, accounting for more than 35% of all R&D investment in the 1,000 top-performing companies.

The Government’s growth review has highlighted life sciences as a key area and has introduced a more competitive tax system to encourage improvements in the sector.

The path to strong, sustainable and balanced growth proposes the introduction of a ‘Patent Box’ tax regime and a review of R&D tax credits to reflect proposals of the Dyson review.

Richard Barker, Director General of the ABPI, says the proposals set the stage for “a resurgence in UK life sciences”.

The introduction of a ‘Patent Box’ would offer a preferential tax regime of 10% for profits arising from patents which are hoped will encourage the commercialisation of discoveries in the UK.

“The introduction of the Patent Box will result in a significant change of attitude towards the UK as a location for R&D and manufacturing,” said Nigel Gaymond, Chief Executive, BIA.

“This will ultimately stimulate interest and investment in the UK’s bioscience companies. We also welcome the opportunity to maximise the opportunities offered by R&D tax credits which are already a vital incentive for smaller businesses.”

The review also responds to a number of issues highlighted in a joint paper submitted by members of the BIA. The key principles include training for the scientists of the future; adequate funding of businesses and for support of basic science; to create an ideal research landscape; improve the uptake and procurement of world leading innovative products; and recognise the need for a longer term strategy.