I spend a lot of my time in contact with my counterparts around the world, and I genuinely think that there is more energy and creativity in the discussion in this country right now on the critical subject of how we can improve access to medicines for patients, how we can do it in a way that safeguards value for money for the NHS, and how in doing so we can make this country the best place to invest in and that’s certainly our mission at the ABPI.
Like others have said, we have the clearest possible example right now of why a healthy nation is so important. Of course we have during this COVID crisis. And it’s also underlined the importance of why we need to have the global capacity to keep innovating, that means innovating with urgency when we’ve got a massive crisis like this.
…Not just in a crisis, how do we make the best of science? I think the way Lord Bethell laid out the three drivers of genomics, AI and big data is a very helpful starting point for this conversation, because I think these drivers do and will allow us to get an ever more targeted and effective means of treating patients, often with rare conditions and often with conditions that are currently untreatable, and that is really what the industry pipeline has been reoriented to serve.
I would argue that we are in a golden age of drug discovery at the moment, where the coming few years really ought to be able to move us on a level in terms of our ability to treat disease.
NICE is an incredibly important institution for the pharmaceutical industry as well. (echoing the comments of others)
Of all of the many ways in which there can be scrutiny on the appropriateness of a medicines price, and there are many ways suggested around the world - international reference pricing, some people would like to base it on R&D costs - I think by a long way, the most rational way of thinking about medicines pricing is to base it on how well a medicine works for patients and at the end of the day that is what NICE is all about. It is all about trying to assess value, to try to quantify that value, and make sure that the conversation about prices is well informed.
One of the things I wanted to mention was that we have a voluntary scheme as an industry in the UK with the Government. In fact, we’ve had a voluntary scheme of one sort of another since the 1950s.
The latest version of it caps the total amount of money that is spent on branded medicines in the UK and that runs until the end of 2023.
It’s a scheme that we are very proud of actually. It gives the NHS and the Government total certainty on the total amount of money (it spends on medicines). But what it also does is it gives us a very sharp lens for the industry to look at NICE and the importance of health technology assessment, and that is partly because the industry pays back to Government any spend beyond the cap that we’ve agreed within the scheme.
What that means is that we have got a very strong stake ourselves in how NICE works, and the methods that it uses to assess. It’s critical to ensure fairness for patients, but it’s also critical to ensure fairness within the industry because of the financial flows associated in our deal.
That might sound a little bit convoluted but it’s actually at its heart really simple. It means that we are a really strong partner to Government in ensuring value for money, we don’t want costs to go out of control, and actually having a reasonable means of fair scrutiny on the prices of medicines is something that we are very committed to.
Our focus on this methods review is really to try and address what we perceive to be a particular set of challenges, with particularly those medicines for rarer conditions – in fact, precisely the sort of medicines that are enabled by developments in genomics, AI, and big data. (which were mentioned by Lord Bethell)
Those happen to be the medicines that tend to systematically have a harder time getting through than many others. As head of the ABPI, it is not my job to defend every pharmaceutical price.
If prices are too high, then the NHS shouldn’t use the medicines and it’s really important that pharmaceutical companies price responsibly.
But in order to judge what does responsible pricing looks like, we have to have a system that is fair across all disease areas, and we believe that there’s increasingly strong evidence to suggest that there are certain types of medicines that typically have a harder time than others, and that’s why in this review we’ve made a few suggestions for some modifications in the methods that will allow particularly rarer diseases to be on a level playing field with diseases in other therapeutic areas.
(Edits were to remove repetition, conversational references to other speakers, and clarify meanings)
...we are a really strong partner to Government in ensuring value for money, we don’t want costs to go out of control, and actually having a reasonable means of fair scrutiny on the prices of medicines is something that we are very committed to.
ABPI Chief Executive Dr Richard Torbett