The life sciences are a crucial part of the UK economy, supporting growth, high-value jobs and trade with other countries. However, the UK’s investment in research and development (R&D) has become less competitive over the past decade. According to the Association of the British Pharmaceutical Industry, the number of clinical trials initiated per year in the UK fell by 41 per cent between 2017 and 2021 compared with other OECD nations. The New Statesman and pharmaceutical company Sanofi organised a roundtable of experts in July 2023, who came together to discuss how to increase investment in UK R&D and create the innovative treatments that can improve patient outcomes and boost the economy. The roundtable was chaired by the New Statesman senior associate editor Sarah Dawood and was conducted under Chatham House Rules.
One attendee said that the UK needed to recognise its history as a leader in science, and better take advantage of this to convert this skills base into a “high-skill, high-wage and high-productivity economy”.
“We have a fantastic heritage, [such as the] discovery of penicillin and the structure of DNA, and we do have a great science base,” they said. “If we were to lose our leading position as a science base, we would be much poorer economically and culturally.”
Another participant pointed out that the UK is still highly regarded in the life sciences with regulatory bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (NICE) seen as “consistent, transparent, high quality [and] reliable”. They added that with the MHRA becoming a sovereign regulator post-Brexit, there are opportunities that come with this change of status, such as bringing new medicines to patients more quickly. However, one challenge is high vacancy rates at the MHRA, in part because of the split from the European Medicines Agency.
They were also worried about tax clawbacks affecting the industry, which mean that when public spending on medicines exceeds certain thresholds, the surplus is repaid by pharmaceutical companies. Clawbacks have risen to 26.5 per cent of sales this year, totalling £3.3bn in revenue, which is nearly double the £1.8bn collected in 2022. This has prompted a drop in investment in UK R&D as it looks “unstable” compared with other countries, said the attendee.
Attracting talent from overseas was another area of concern. “Our ability to attract the best international talent is really crucial for any kind of superpower ambition,” observed one person. But prohibitively high work-visa costs are putting off researchers from abroad, another attendee noted, while other European countries offer free or much cheaper rates.
The state of the NHS was a key concern to many, who felt that without a strong health service, the government’s ambitions to become a “life sciences superpower” will fall short.
“If the NHS can’t do its day job, it cannot have the capacity to drive through innovation,” said one attendee. It was also noted that changing hierarchical team structures, greater transparency in decision-making within NHS trusts, and allowing for more multidisciplinary teams who can all contribute, would help to drive forward innovation. A bigger focus on prevention, rather than treating sickness, was also highlighted as a means of relieving pressure on the NHS and giving staff the capacity to engage in more innovation.
Another attendee noted that the regulatory system, while robust, is currently too difficult to navigate, and is stifling the ability to bring new medicines to market quickly: “I believe we’ve got to simplify the procurement and adoption process to make it easier for innovators to get their products into the NHS,” they said.
Clinical trials were discussed as a crucial area that needed reform; for instance, the question was posed around whether a more centralised approach to conducting trials would help to increase participation, which has helped in Scotland and Wales, as well as a stronger mandate on NHS Trusts to participate in research. The major challenge is capacity; many trusts do not have the time or resources to cooperate fully with clinical research. “When you’ve got a million and one things going on, do you necessarily have the headspace to enact [research]?” said one attendee. “And how do you actually make a duty to innovate, or to research?”
“Clinical trial networks” were also suggested as a mechanism to speed up clinical research – these would entail a series of linked centres across different locations with the same protocols and systems in place. Another attendee suggested designating “innovation champions” for each NHS trust or treatment area, who could lead on driving innovation in their specialism. Promoting cross-sector mobility, such as by moving staff between hospitals and research institutes, was another suggestion to enable more clinicians to engage with research. “It’s so important to change that culture within the NHS to a pro-research culture so that you’ve got really intelligent consumers within the NHS,” they said.
Ensuring equitable access to new treatments across different regions and demographics was also discussed as an important consideration. Tackling varying vaccine uptake rates within marginalised communities was discussed, while another attendee reflected on how more work needed to be done to understand this challenge – for example by making a commitment to improve diversity in clinical trials, consulting more with the public, and learning more about individuals’ lived experiences. Access to data is also key to understanding inequalities on a local level, added another attendee, not only in vaccine uptake but in major conditions such as diabetes and heart disease. “I think it [data] tends to be used for performance management and it should be used to support decisions on services,” reflected one person.
On a political level, participants felt there was a need for longer-term strategic vision and more consistent leadership to enact change, noting the high turnover of science ministers over the past five years. “That broad political environment for research in the UK [is] really important,” one person observed. Ultimately, collaboration between the NHS, industry and government will be crucial and enable innovative products to come to market more quickly, as they did during the pandemic. “If we work together, as we did in Covid, we can do more,” said one attendee.
This event and write-up has been organised and funded by Sanofi as part of its activities to support discussions on the key health challenges facing the UK
MAT-XU-2304071 | August 2023