The UK’s Prescription for the Future?

Jun, 2024 | Pharma

“By delivering a supportive policy and operating environment for medicines manufacturing, the UK could attract £15bn and create an additional 26,500 jobs over the next 10 years.”

MMIP Report

https://www.abpi.org.uk/media/he0p1ojq/mmip-2023-report.pdf

The UK’s life sciences sector is at a critical juncture. Over the past decades, the innovative pharmaceutical industry has made profound contributions to public health, developing transformative treatments that have extended and improved the lives of millions. At the same time, the industry’s economic impact has been immense, driving research and development (R&D) investment, supporting high-skilled jobs, and generating significant tax revenues.

Yet the sector now finds itself facing intensifying global competition, with other nations aggressively courting the industry’s prized assets and expertise. Meanwhile, the National Health Service (NHS) has grappled with the dual challenge of constrained budgets and the rising costs of newer, more innovative medicines.

Against this backdrop, the Association of the British Pharmaceutical Industry (ABPI) has laid out a bold vision for the future – a manifesto that aims to cement the UK’s status as a global life sciences superpower, while also ensuring that NHS patients can access the cutting-edge treatments they need. It’s an ambitious agenda, to be sure, but one that deserves careful consideration.

The Virtuous Cycle of Innovation

The starting point for the ABPI’s manifesto is the recognition that the UK’s life sciences sector can be a powerful engine of economic growth – but only if the right conditions are in place. As the ABPI notes, the industry already accounts for around £9 billion in annual R&D investment, making it the top-spending private sector in the UK. Crucially, this R&D activity generates significant spillover effects, contributing an estimated £45 billion to the broader economy.

Harnessing this potential will require a concerted, collaborative effort between industry and government. The ABPI’s first key ask is to “strengthen the development, regulation and adoption journey for new medicines and vaccines, making the UK a beacon for global research investment.” This would entail creating a more joined-up “life sciences ecosystem,” with greater alignment between regulatory bodies, health technology assessment (HTA) agencies, and the NHS.

The aim is to address a longstanding challenge: the UK has frequently lagged other countries in the uptake of new medicines, even after they have received regulatory approval. Under the current system, a drug may clear the initial hurdle of regulatory approval, only to face delays at the HTA stage or in the NHS commissioning process. Streamlining this journey, the ABPI argues, would not only benefit patients, but also help to attract greater investment in UK-based R&D.

Notably, the manifesto calls for the UK to set a target of having the highest level of public R&D investment among the G7 countries. This would signal a clear commitment to supporting cutting-edge science and innovation, building on the country’s existing strengths in areas like genomics and cell and gene therapies.

Equally important is the ABPI’s push to reverse the decline in industry-sponsored clinical trials in the UK. During the pandemic, the number of such trials dropped sharply, and the recovery has been slower than in other nations. Restoring the UK’s appeal as a destination for global clinical research will be crucial, both for patient access to innovative treatments and for maintaining the country’s status as a life sciences hub.

Alongside these efforts, the ABPI advocates for the creation of a “seamless pathway” connecting genetic testing, personalised medicines, and clinical trials. This would help to ensure that patients can more readily access tailored therapies and participate in trials that could offer life-saving opportunities. Additionally, the manifesto calls for the development of a world-class, data-enabled patient recruitment service for clinical trials, as well as broader improvements to the UK’s health data infrastructure.

Taken together, these initiatives are designed to create a virtuous cycle. By making the UK an attractive destination for global R&D investment, the country can accelerate the development and adoption of new medicines and vaccines. This, in turn, would enhance the UK’s reputation as a life sciences leader, drawing in ever-greater levels of research activity and cementing the sector’s contribution to the nation’s health and wealth.

A Sustainable, Equitable Approach to Medicine Access

While the ABPI’s vision for boosting R&D and innovation is undoubtedly compelling, the manifesto also grapples with the crucial issue of patient access to new medicines. Here, the industry group is making a clear-eyed assessment of the UK’s current challenges and proposing a collaborative path forward.

The stark reality is that the UK has historically lagged behind many of its international peers when it comes to the uptake of new medicines. This has contributed to suboptimal health outcomes, with the country ranking 16th and 18th, respectively, among 19 comparable nations for preventable and treatable causes of mortality.

Underlying this access gap is the growing tension between the NHS’s constrained budget and the rising costs of innovative therapies. As the ABPI notes, spending on medicines has grown significantly as a proportion of the overall NHS budget, rising from around 12% in the early 2000s to over 15% today. This trend has put increasing strain on healthcare resources, fueling concerns about the sustainability of the system.

In response, the ABPI is calling for a true partnership between industry and government, centred on the principle of “investing in medicines and vaccines to improve prevention and health equity and deliver a sustainable NHS.” Key to this is the delivery of commitments made under the Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG) – an agreement that aims to strike a balance between fair pricing for the NHS and reasonable returns for industry.

Crucially, the ABPI is also advocating for reforms to the way that the long-term health benefits of new medicines are evaluated and valued. This includes urging the National Institute for Health and Care Excellence (NICE) to adopt a modified discount rate that more accurately captures the full impact of transformative therapies, particularly in areas like cell and gene therapy.

Additionally, the manifesto calls for the revamping of the Innovative Medicines Fund (IMF) in England. Established in 2022 with a £340 million budget, the IMF was intended to provide early patient access to promising new treatments. However, overly restrictive entry and exit criteria have so far prevented the fund from being used for its primary purpose. Reforming the IMF to make it more accessible could allow the UK to lead the world in delivering cutting-edge medicines to patients.

Looking ahead, the ABPI is also highlighting the need for a more proactive, system-wide approach to horizon scanning for the next generation of vaccines. With nearly half of the current vaccine pipeline targeting conditions for which no vaccines currently exist, the industry group argues that better preparation and planning could help the NHS deliver new immunisation programmes more quickly and efficiently.

Underpinning all of these proposals is a recognition that improving access to innovative medicines is not just about benefiting patients – it can also deliver substantial economic dividends. Research by PwC has shown that if the UK increased use of just four types of NICE-recommended medicines, it could generate £17.9 billion in productivity gains and £5.5 billion in tax receipts for the Exchequer. In other words, investing in medicines can be a win-win for both public health and the nation’s economic prosperity.

Equipping the Industry for Success

The ABPI’s manifesto is not solely focused on the NHS and patient access, however. It also lays out a series of asks aimed at “equipping industry with the tools to drive UK economic growth” – a critical component of the overall vision.

The starting point is the recognition that the UK is facing increasing global competition for life sciences investment. In the aftermath of the pandemic, nations around the world have launched targeted strategies to attract the industry’s prized assets and expertise. As a result, the UK’s share of global pharmaceutical R&D spending has declined from 4.9% in 2012 to just 3.3% in 2020.

To maintain the UK’s edge, the ABPI is calling for a multi-pronged approach. This includes strengthening the country’s position in global trade frameworks, such as by continuing to advocate for robust intellectual property protections and the elimination of tariffs and export restrictions on medicines.

Crucially, the manifesto also urges the government to leverage the full range of its trade policy toolkit – from free trade agreements to regulatory diplomacy – to promote UK life sciences exports as a key growth sector. Given the industry’s £26.1 billion in annual exports, this could yield substantial economic dividends.

Alongside these trade-focused initiatives, the ABPI is pushing for a truly cross-departmental approach to skills and education policy. This would involve reforming the apprenticeship levy to better support the industry’s training and upskilling needs, as well as ensuring that visa costs and processing times are internationally competitive to attract global talent.

Perhaps most ambitiously, the manifesto calls for the UK to become a “world leader in advanced and sustainable medicines manufacturing.” This would entail a long-term program of capital grants and innovation funding, building on the £520 million Capital Grants Programme for Life Sciences Manufacturing and complementing industry-led initiatives like the £78 million voluntary scheme investment in sustainable manufacturing.

By delivering on these proposals, the ABPI believes the UK can not only cement its status as a global life sciences hub, but also reap significant economic rewards. According to analysis cited in the manifesto, getting the policy settings right could attract £16.4 billion in new medicines manufacturing investment and double the number of industry employees over the next decade.

Balancing Patients and Profits

At its core, the ABPI’s manifesto is about more than just advancing the interests of its member companies. While the industry group is understandably focused on creating an environment that fosters innovation and growth, the document also places a strong emphasis on improving patient outcomes and ensuring the long-term sustainability of the NHS.

This dual focus is evident throughout the ABPI’s proposals. For example, the call to streamline the development, regulatory, and adoption journey for new medicines is explicitly framed as a means of “making the UK a beacon for global research investment” – but the ultimate goal is to accelerate patient access to transformative treatments.

Similarly, the push for reforms to the way that health technology assessment (HTA) bodies evaluate the long-term benefits of innovative therapies is motivated by a desire to ensure that truly valuable medicines can reach patients, rather than simply protecting industry profits. As the manifesto notes, adopting a modified discount rate could “increase the chance of patients getting access to new medicines on the NHS, such as cell and gene therapies.”

Crucially, the ABPI is also advocating for greater investment in prevention and health equity – areas that may not necessarily translate into immediate commercial gains for pharmaceutical companies, but that are vital for improving population-level health outcomes. This includes calls for dedicated funding to combat the looming threat of antimicrobial resistance, as well as efforts to prepare the ground for the next generation of innovative vaccines.

To be sure, the manifesto does not shy away from the industry’s economic interests. The ABPI is unequivocal in its desire to see the UK retain its competitiveness as a global hub for life sciences investment and to equip the sector with the tools it needs to drive growth. But these commercial concerns are presented as complementary to, rather than in conflict with, the needs of patients and the healthcare system.

Indeed, the ABPI makes a compelling case that improving access to innovative medicines can yield substantial economic dividends – not just for the industry, but for the broader UK economy. By quantifying the potential productivity gains and tax revenues associated with greater medicine uptake, the manifesto demonstrates how investing in patient health can also translate into tangible financial benefits.

This alignment of interests is a key strength of the ABPI’s vision. Rather than pitting the industry against the NHS or patients, the manifesto seeks to establish a true partnership – one in which the pharmaceutical sector’s commercial success is directly tied to its ability to deliver meaningful improvements in public health and healthcare sustainability.

Of course, realizing this symbiotic relationship will require a delicate balancing act. The ABPI acknowledges the ongoing tensions around medicine pricing and the need to ensure that innovation doesn’t come at the expense of NHS budgets. But by approaching these challenges collaboratively and transparently, the industry group believes it can chart a path forward that benefits all stakeholders.

A Collaborative, Transparent Approach

Underpinning the ABPI’s manifesto is a recognition that realising this ambitious vision will require a genuine, collaborative partnership between industry and government. The document emphasizes the importance of “transparency of delivery” and a “unified approach to health and growth” – principles that will be critical to building trust and aligning incentives.

This collaborative spirit is evident in the ABPI’s calls for regular engagement between industry, academia, and policymakers to address current and future skills needs. It’s also reflected in the group’s proposals for co-designing research funding programs and innovation challenges with government partners.

Importantly, the manifesto acknowledges that the industry itself has an important role to play. By working transparently with the NHS and other stakeholders, the ABPI believes the pharmaceutical sector can help to demonstrate the value of its innovative treatments – not just in terms of clinical outcomes, but also in areas like productivity, tax revenues, and health system sustainability.

Of course, translating these ideas into tangible progress will require deft political leadership and a long-term, cross-party commitment. The ABPI’s manifesto is unequivocal in its call for the next government to embrace this agenda, presenting it as a unique opportunity to cement the UK’s status as a global life sciences superpower.

The stakes are high, but so too are the potential rewards. By getting the policy settings right, the UK can harness the transformative power of the pharmaceutical industry to improve public health, drive economic growth, and secure its place at the forefront of the life sciences revolution. It’s an ambitious vision, to be sure, but one that deserves serious consideration from policymakers and the public alike.

Reference(s)

  1. https://www.abpi.org.uk/about-the-abpi/abpi-manifesto-for-investment-health-and-growth/

 

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About the Author

  • Dilruwan Herath

    Dilruwan Herath is a British infectious disease physician and pharmaceutical medical executive with over 25 years of experience. As a doctor, he specialized in infectious diseases and immunology, developing a resolute focus on public health impact. Throughout his career, Dr. Herath has held several senior medical leadership roles in large global pharmaceutical companies, leading transformative clinical changes and ensuring access to innovative medicines. Currently, he serves as an expert member for the Faculty of Pharmaceutical Medicine on it Infectious Disease Commitee and continues advising life sciences companies. When not practicing medicine, Dr. Herath enjoys painting landscapes, motorsports, computer programming, and spending time with his young family. He maintains an avid interest in science and technology. He is a founder of DarkDrug

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