I am amazed when I reflect on technological advances since the turn of the century. Most of us can probably remember our first mobile phone or using email for the first time, and now Google processes over 40,000 search queries every second.
While gadgetry and connectivity have made a significant impact on our lives, I would argue that scientific innovations in the medical sector have been the most exciting. For example, our understanding of cancer has matured to such a degree that we are now able to pinpoint and exploit the vulnerabilities of cancer cells with targeted medicines. Significant progress has also been seen for people with other diseases, from hepatitis to HIV, and multiple sclerosis to macular degeneration.
Research in British laboratories and patient participation in clinical trials have made a significant contribution to this golden age of medical science. For example, at AstraZeneca we apply a precision medicine approach to select the right patients for treatments and have been able to significantly speed up the development process for new innovative medicines. Our ambitious genomics strategy, launched in April 2016, aims to analyse up to two million genomes by 2026. This will enable us to identify new targets for medicines and understand which patients are most likely to benefit from each one.
But while the UK life sciences industry is an incredibly stimulating place to be right now, the processes for making these medicines available to patients in the UK have been slow to adapt. As medicines development has changed and continues to evolve, the access system must have the capacity to respond positively to new technologies. In the same way that AstraZeneca is working with government to make the UK the best place in the world to discover and develop medicines, we also want to ensure these medicines can benefit patients in this country.
All healthcare systems face challenges, and rarely a week goes by when the NHS isn’t in the headlines. But the truth is our nation’s health is not the responsibility of any one person or organisation. We need to work together to ensure the system is hardwired to translate medical advances into improved patient outcomes. Patient access to new medicines in the UK is slower than in many comparable countries. The government’s Life Sciences Indicators show that the uptake of medicines approved by NICE as cost-effective was just 18 per cent of the international average of other similar countries in the first year after launch.
While it is extremely complex to directly correlate lower medicines access with poorer health outcomes, there are trends that suggest this. For example, the UK has one of the lowest uptake rates of new cancer medicines compared to the four largest European economies (Germany, France, Italy and Spain); the UK also has the highest mortality rate from cancer compared with these countries. So while there are other factors at play, there is a case to be made for taking a good hard look at the current medicines access framework, and asking whether it’s working for UK patients.
We need to seize opportunities for the future. We support the ambition in the recently published Life Sciences Industrial Strategy (LSIS) that the UK should be positioned in the top quartile of comparator countries for the speed of adoption and the overall uptake of new medicines by 2023. We also support the proposals to improve patient access to new medicines while ensuring value of the health service and urge government to respond to them as a priority. We are ready to support this effort.
Unlocking innovation for patients
Once a medicine has been deemed cost-effective and is approved for use in the NHS, the next step is to ensure it is used in an optimal way to enable the highest standards of care and best outcomes for patients. This is very much easier said than done, with variations in access to NICE-approved medicines across the UK; however, there are many examples of local teams working in innovative ways to achieve this goal.
The pharmaceutical industry has supported some of this work through collaborative working. These are mutually beneficially partnerships where we pool skills and resources with the NHS to improve health outcomes in our areas of expertise. AstraZeneca has collaborated with the NHS on over 30 initiatives across the UK.
One current example is the Cardiovascular Partnership programme, created by AstraZeneca to provide clinical leadership and support to the NHS in addressing unwarranted variation in the non-ST elevated myocardial infarction (NSTEMI) pathway. With input from multiple stakeholders, including a consultant cardiologist with experience in service redesign, we have hosted a number of workshops with hospitals and have conducted an innovative analysis of hospital data enabling trusts to understand their patient journeys. As a result, participating trusts have made several changes, concentrating on reducing the time to intervention and length of hospital stay.
In summary this initiative has provided value to the NHS and has supported a limited number of trusts due to capacity. We are now looking for support from the NHS to take the learnings forward, use the data and address system-wide improvement.
AstraZeneca and the pharmaceutical industry has expertise, resources and ideas for how the NHS can sustainably adopt new technologies and innovative medicines at scale. Equally, the NHS has huge potential to drive the life sciences industry to the benefit of the British economy – for example, by working in partnership to harness the power of medical data; delivering more clinical trials and research; and supporting the development and greater use of precision medicines and genomics. Collaboration is the key to unlocking the benefits of innovation for all.
Elena Tricca is director of market access and government affairs at AstraZeneca UK.