Transcript Alison Clough

How can the Pharma Industry
assist the NHS in constrained
times?
Can Pharma help with QIPP?
PDIG meeting, 10 June 2010
Alison Clough
Commercial & Communications Director, Association of the
British Pharmaceutical Industry
The environment is getting
tougher
Ageing demographic
Increasing demand on healthcare
resources
Economic slowdown
Acceleration of technical
advancement
Win- win-win
Patient
Outcomes
QIPP
For
NHS
Innovation
from
Pharma
industry
Partners in Improving Care and Healthcare Delivery
November 2009
Through the continued process of innovation in the UK, further benefits can
Innovation fuels better patient
outcomes
•1 in 5 of the
leading medicines
used around the
world were
developed by a UK
Company
• Increase in life
expectancy over time
Prescription for innovation (ABPI 2009); WHO (2006)
Coronary heart disease
Age standardised mortality rates in population
aged 15-74, circa 2005
140
120
100
80
60
40
20
U
ni
la
nd
Ire
om
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er
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en
Sw
ed
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ia
A
us
ay
N
or
w
ly
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ai
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nd
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Sw
itz
Fr
an
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0
OHE calculation based on WHO Mortality Database (WHO), Mortality Statistics Series DH2 (ONS), Mortality Statistics Deaths Registered DR_06 (ONS), Vital Events
Reference Tables (General Register Office of Scotland), Demographic Statistics (Northern Ireland Statistics and Research Agency), Population Estimates and Projections
(ONS).
Mortality rates from disease remain high - there
remains scope for further improvement in
public health
Heart and circulatory
disorders –leading
cause of death in
England in 2007,
resulting in 158 500
deaths (34% of all
deaths)
Cancer responsible for
23% of all deaths
Atlas of Risk (NHS 2009) Slide reproduced courtesy of Pfizer
34%
23%
Medicines Life Cycle in UK ...
delivering efficiencies but out of balance ...?
UK has slow & low
use of innovative
medicines
The UK has amongst the
lowest market share of
new medicines across
Europe
Encourage
Innovation
Source: Compendium of Health Statistics 2009 (OHE), updated Hospital prescribing data (IC) PPA and PCA data. Market Statistics IMS World Review, OECD
GDP data. PPRS reports to Parliament 6th and 10th IMS world review EGA National Association 2007.
Comparatively, UK has low new
product uptake
Source: IMS world review
Medicines Life Cycle in UK ...
delivering efficiencies but out of balance ...?
UK has slow & low
use of innovative
medicines
The UK has amongst the
lowest market share of
new medicines across
Europe
Encourage
Innovation
UK prices are
amongst the
lowest in Europe
3 price cuts
since 2005
Maximise value
for patient,
NHS &
Industry
Source: Compendium of Health Statistics 2009 (OHE), updated Hospital prescribing data (IC) PPA and PCA data. Market Statistics IMS World Review, OECD
GDP data. PPRS reports to Parliament 6th and 10th IMS world review EGA National Association 2007.
UK prices lowest in official PPRS Report to
Parliament-December 2009
Table: price index for top 150 UK branded medicines (UK = 100)
Bilateral comparisons of ex-manufacturer prices (sources PPRS reports to Parliament 6th and 10th)
2000 DH
estimate
2000 Rank
2006 DH
estimate
2006
Rank
2008 DH
estimate
2008
Rank
USA
Germany
Ireland
Belgium
Finland
Netherlands
Austria
France
Sweden
Spain
Italy
209
91
83
78
83
81
77
80
Na
64
79
1
3
=4
9
=4
6
10
7
11
8
188
105
105
97
96
94
94
89
103
85
78
1
=2
=2
6
7
=8
=8
10
4
11
12
252
142
134
122
119
115
111
108
116
109
101
1
2
3
4
5
6
7
8
9
10
11
UK
100
2
100
5
100
12
Medicines Life Cycle in UK ...
delivering efficiencies but out of balance ...?
UK has slow & low
use of innovative
medicines
UK prices are
amongst the
lowest in Europe
3 price cuts since 2005
UK has very
efficient use of
generics
• 83% generic prescribing
• 65% by volume is generics
• Average price of generics
amongst lowest in Europe
The UK has amongst the
lowest market share of
new medicines across
Europe
Encourage
Innovation
Maximise value
for patient,
NHS &
Industry
Efficiency
Source: Compendium of Health Statistics 2009 (OHE), updated Hospital prescribing data (IC) PPA and PCA data. Market Statistics IMS World Review, OECD
GDP data. PPRS reports to Parliament 6th and 10th IMS world review EGA National Association 2007.
The UK is amongst the EU markets with
largest penetration of generics, with ~65%
of volume
Generics market share in Europe (2006)
Generics share of volumes (%)
Generics share of value (%)
2009 UK generic
prescribing rate
=83%
Source: EGA National Association 2007
Medicines Life Cycle in UK ...
delivering efficiencies but out of balance ...?
UK prices are
amongst the
UK has slow & low lowest in Europe
use of innovative
3 price cuts since 2005
medicines
• 83% generic prescribing
• 65% by volume is generics
• Average price of generics
amongst lowest in Europe
The UK has amongst the
lowest market share of
new medicines across
Europe
Encourage
Innovation
UK has very
efficient use of
generics
Maximise value
for patient,
NHS &
Industry
Efficiency
Only 1% GDP is spent on medicines in UK cf EU average 1.5%, Fr 2%, Greece 2.3%
Source: Compendium of Health Statistics 2009 (OHE), updated Hospital prescribing data (IC) PPA and PCA data. Market Statistics IMS World Review, OECD
GDP data. PPRS reports to Parliament 6th and 10th IMS world review EGA National Association 2007.
Total Medicines Bill as a % of NHS spend has
been in sustained decline since 2004
NHS spend and Medicines Bill as a percentage of the NHS costs 1998-2008
Annual Spend (£billion)
%
140
14
120
12
NHS expenditure (2008 prices)
100
10
NHS Medicines bill % NHS cost
80
8
60
6
40
4
20
2
0
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
PPRS (01/10/1999)
4.5%
PPRS (01/01/2005)
7.0%
Source: Compendium of Health Statistics 2009 (OHE), updated Hospital prescribing data (IC) PPA and PCA data
PPRS (01/01/2009)
3.9% + GS
Economic picture
• The medicines bill is already delivering
efficiencies and is under control.
• Important to meet NHS / health needs as well
as economic /industrial policy.
• Pharma is one of the key industries
underpinning economic recovery.
Driving health & economic
benefit for the UK
Opportunities for industry
participation in QIPP
• Joint working - implement national strategies for long term
conditions or tackle local priorities
– Many examples contained within the ABPI/DH
‘Moving Beyond Sponsorship’ Toolkit.
• Support for the redesign of care pathways - ensure the
appropriate use of innovative new medicines.
• Management support to review processes & support change
programmes.
Happy Hearts Project
Aim- to find and treat ‘hard to reach’ patients with multiple CVD
risk factors and improve patient care and services in
Nottingham.
• Nottingham City PCT and six companies with ABPI
• Primary care based CVD risk identification and management
• Nottingham mortality rates significantly higher than the
national average.
• Targeted at 13 GP practices in most deprived areas
Identified 1352 patients (66%) with a risk level of >20%.
Patients were given support to manage and reduce that risk
including appropriate medication.
Partners in Improving Care and
Healthcare Delivery
Driving Health and Economic
Benefit for the UK