At long last, we are having a General Election. Regardless of your political persuasion, I suspect most people working in Government Affairs in the life sciences sector are looking forward to a change.
Thankfully, we have some idea already of what that change might look like. Our team at PLMR Healthcomms have analysed Labours’ Health, Life Sciences and Business Strategies and what the leading proposals mean across pharma, med tech and digital.
Each of these strategies has been met with support from industry. And no wonder – a new Government will inherit a life sciences industry that feels it has been undervalued politically with some major challenges to solve in the commercial environment. So, what should a new set of Ministers be thinking about to ensure a thriving life sciences sector?
1. Access and uptake: As set out in the ABPI’s manifesto, the industry will always seek strategic collaboration on areas such as adoption, R&D, IP and advanced manufacturing. But behind the scenes, spec com devolution, incorporating NICE TAs into clinical guidelines and the upcoming consultation on the NHSE Commercial Framework are causing concern. These are the just the latest in a long series of initiatives that industry does not believe will provide the choice, flexibility and uptake that they say that they, and patients, need.
On the other hand, the system is not the bad guy. It wants to provide the best flexibility and the best access at the best price. Civil servants recognise the desire to speed up adoption. But the strategy for buying medicines in the NHS is impacted by the political choice as to how much the UK is willing to spend. As care becomes more personalised, and the parameters of existing regulatory and value assessment mechanisms continue to be challenged, a new Government will find they can no longer avoid political intervention on this question.
2. Resilience: In recent weeks, the urgent situation on medicines shortages has come to the fore. Medicines shortages is a global challenge (there are even shortages of cancer therapies in the USA) that has been a challenge for civil servants for some time. But it has been ignored politically in the UK at the highest levels for too long, with the chief executive of Community Pharmacy England recently describing the situation as ‘beyond critical’. Mark Samuels of the BGMA said in February that medicines shortages are double what they were a year ago. It is a matter of time before this spills over and impacts patient care, and a new Government will not want to be left with the blame. A supply chain resilience strategy should be on their radar urgently.
Part of that resilience strategy needs to involve manufacturing. Medicines manufacturing capacity in the UK has fallen by 29% since 2009, and since 2010, the UK has fallen to 98th in the world in its trade balance for pharmaceuticals. We have heard a lot about skills, capacity and unlocking funding, but not much about the fundamental question of how, and if, it is possible to make manufacturing in the UK more attractive for companies as well as affordable. That key question is what will draw companies back to the UK.
3. Data: Another area that has gone under the political radar is data. The potential for improved informatics from data in the NHS has been a hot topic for many years, but it hasn’t materialised. With respect to medicines a lot of data is collected but isn’t converted to useable intelligence. There is no central directory for medicines in the NHS, nor are medicines routinely linked to health outcomes. This impacts not just the cost of medicines but hinders the assessment of clinical and cost-effectiveness in the real world.
Investment (commitment as well as funding) can bring existing, but siloed, datasets together, and create a single point of truth to enable real time reporting and linkage to understand appropriate medicines use. A new Government should be considering a new medicines data strategy that links all parts of the patient journey with medicines, so the system can adopt a more data driven approach and maximise the effectiveness of the medicines budget.
4. Stability: Since 2016, at DHSC we’ve seen five Health Ministers in the Lords, seven Secretaries of State, eight Ministers of State and 10 Parliamentary Under Secretaries of State. The NHS and life sciences sector do not cope well with constant change, instead needing long-term planning and certainty. Most ministers coming through DHSC in recent years (bar a few) have not had the time to grasp the complexities of the sector and this has left them short. Whoever is appointed as Life Sciences Minister, they should be someone who is ready for the challenge and ready to champion the sector for the long-term.
Overall, the pharmaceutical sector is one of the few that has genuine potential to transform the UK. Partnered with AI and digital, we could see drug development, trials and treatment reach incredible heights. The UK performs well at being one of the first to access innovations, for example CAR T, Covid-19 vaccines and surgical robotics. We also – with the exception of the supply issues mentioned earlier – perform well on access to everyday medicines. It isn’t commonly known that drugs are the second highest area of spend in the NHS and the most common intervention. Medicines is often seen as the envy of other parts of the health system, reflected in the number of positive news stories we hear about medicines coming from the NHS, at a time when good news stories are uncommon.
Yet, this is a sector that feels like it is muddling through. We haven’t seen enough political recognition of the value of the life sciences sector, or enough political leaders willing to champion it. The medicines shortages situation highlights the human impact of when things go wrong.
The reality is that whilst we won’t hear about the plights of the life sciences industry in the build up to an Election, there are several issues that need to be fixed. James O’Shaughnessy showed through his review of clinical trials that it is possible to think strategically about the challenges facing the health system and about how to achieve common benefit for industry, the NHS and patients. Maybe what is needed from Labour, rather than a Life Sciences Strategy, is a series of them. Whether they will be bold and brave enough to take on this challenge will be the key question facing the industry.
