What has 2017 taught us and what hope is there?

Amy Schofield 11 December 2017


’17 Again

2017 was marked by more political uncertainty, as Theresa May called a snap General Election, which backfired spectacularly. Meanwhile, Brexit ‘negotiations’ rumbled on (and continue to), the NHS buckled further under the strain and every industry – not least the pharmaceutical sector – faced yet more insecurity. So, what challenges faced pharma and the NHS, and what’s next?


POLITICS: Where’s the money?

Simon Stevens gave an impassioned speech at the NHS Providers conference, demanding the £350m-a-week promised to the NHS by the Leave campaign, pointing out that: “The NHS wasn’t on the ballot paper, but it was on the battlebus – ‘Vote Leave for a better funded health service – £350m a week’”. At the time of going to press, there was no sign of the cash materialising.



Pharma & NHS

Reality bites: David Thorne, Managing Director, Blue River Consulting and Pf Magazine columnist

2017 saw the NHS attacking supply and demand. Some blunt weapons are being used – increased waiting times, reduced fixed costs through consolidation, restrictive procurement of material and rationing. The NHS isn’t good at promoting self-care and preventative better health, so it depends on shutting demand valves.

It wouldn’t be so bad if there was a public mandate for any of this but, instead, we have occult measures used to restrict IVF, deny surgery to smokers or the obese, and waiting times gamed to stimulate use of self-pay.

Disruptive change is happening in ways that mean the endpoint of integrated health and care partnerships is being reached through a nebulous maze of temporary organisational acronyms. The NHS reality is driving change via inadequate funding, social care collapse, reduced quality of care and an ageing, inflexible workforce.

For pharma this means a 2018 of focused de-prescribing plans, intense price pressure and coordinated action to minimise uptake of targeted products. There is a real risk of pharma being reduced to a basic commodity market. Ask any CCG Chief to name five medicines and see what happens!

Pharma needs to get ahead of change and find a place in the future system where it can plant its flag of value. The NHS needs help on vaccination and immunisation campaigns, early diagnosis, safety, RightCare and much more. United cross-company work is urgently needed for a positive approach to emphasising the vital place in healthcare of ethical medicines.



DIGITAL: Remote Renaissance

Andrew Davis, Chairman, neoNavitas

In 2017 the NHS in England became even more complex than ever before. The variables that define a health economy are so many and diverse that we are dealing in segments of one. This heightens the need for local solutions, designed with the customer, that genuinely address patient needs, provider ambition and commissioner goals.

The complexity of differing organisational footprints need not be as challenging to address as it initially seems. The key individuals remain, but their organisations may have changed. Building relationships with these key individuals, deploying teams
with the ability and mandate to engage and deliver on a shared agenda, and engaging head office in a sales enablement drive are strategies that transcend changes in NHS structure and create significant competitive advantage.

2017 also saw the development of remote private and NHS consultations. Could this be the catalyst for the renaissance of primary care? The issue for GPs has been the time required to deliver quality care to those who need it most, and opportunities to create more income. Reducing unnecessary GP consultations would allow GPs to carry out both. 2018 is going to be an exciting year.


ABPI: Code breakers 

A 2017 report showed that breaches of the ABPI code of practice have risen sharply. The Prescription Medicines Code of Practice Authority’s (PMCPA) annual report shows that companies in breach of the code, following complaints received in 2016, include Astellas Pharmaceuticals UK, AstraZeneca UK, Eli Lilly, GSK UK, Merck Sharp & Dohme, Novartis Pharmaceuticals UK and Roche Products. According to the PMCPA, the most common cause of complaint is around claims companies make about their products.



Brexit: the opportunities

Leslie Galloway, Chairman, Ethical Medicines Industry Group (EMIG)

Ongoing Brexit negotiations can be summarised as the greatest uncertainty to face the UK pharma industry and, therefore, our future healthcare and the economy.

This is because ‘no deal’ will mean the UK will likely be relegated in the global sequence of new medicine launches. The implications being that, in future, new medicines would be launched in the EU-27 up to two years before they would in the UK. Such a change would have significant consequences for standard of care, clinical research, the economy and, crucially, patient welfare.

We can lobby as much as we want, but we have little control over how the Commission behaves or how our Government responds, since we are in the midst of exceptional political instability.

We should also remember that the UK does not control its position in global pharmaceuticals. We are 3% of the global market and currently perceived as the English-speaking gateway to the EU. That may well change and the people who will make those decisions are the global pharma decision makers, mostly based in the U.S., Japan and the EU.

How do we compensate for this potential loss of influence over our future?

The answer is: where we have much more control – in the UK and with the Pharmaceutical Price Regulation Scheme, which will be renegotiated in 2018.

It is widely accepted that the current scheme is not working. There are a number of changes we could make, however, which would not only make it work, but create a positive image for the UK as a global centre for innovation.

The most significant change could be the creation of a new medicines fund, underwritten by industry rebates, and aimed at medicines approved by NICE and those with specialised services commissioning policy. Such a scheme could obviate the need for NHS Affordability criteria and the QALY threshold.

These opportunities are within our grasp and could make the UK a global centre, not just an offshore island next to the main market. 


HEALTHCARE: Agile response

Samir Paul, Director, Inicio Consulting

2017 has been an interesting year in pharma and healthcare. Maximising the impact of commercial brand strategies in an ever-complex multi-stakeholder environment, efficiencies being driven in the NHS with potential pricing reforms and the increasing voice of the patient, have meant that as an industry we are having to adapt. The ability to show agility and be able to respond to the needs of customers and patients has never been more important.    


Therapy breakthroughs 


Sanofi and NIH researchers have developed genetically engineered ‘three-in-one’ antibodies as a potential breakthrough intervention for HIV/AIDS, which have the highest activity and breadth of coverage yet seen against HIV1.


Novartis’ advanced breast cancer drug Kisqali (ribociclib) became the first cancer treatment recommended by NICE under the updated cancer appraisal process, giving women with the most common form of advanced breast cancer the possibility of living an average of two years without their disease progressing.


Trials by University of Leicester researchers on Novo Nordisk’s once-daily pill, semaglutide, show a decrease in blood glucose levels and ‘meaningful’ weight loss in up to 90% of patients over three months, potentially ending the need for insulin injections.


In November, billionaire Bill Gates announced a personal $50m investment into the Dementia Discovery Fund to boost research into the underlying causes of the disease. It will also improve dementia diagnosis and participation in trials, bringing new ideas and theories into the field, and use the power of big data to speed up research progress.




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