Speeding up medicines approval would help attract the UK’s new best friend – big pharma
Right now, the UK and big pharma are joined at the hip. The major drug companies can do no wrong in the eyes of the politicians, media and public. They’ve played a blinder as far as providing Covid-19 vaccines is concerned.
This would be the time, then, to strike a new concordat, one that would not only benefit the country health-wise but also economically. Since I wrote for Reaction about the recently announced closure of the GSK plant in Ulverston, in Cumbria, and how the factory was targeted for expansion amid great fanfare when David Cameron was in charge, I’ve been contacted by the pharmaceutical lobby.
It’s true, as I pointed out, that we no longer have any factories in the UK capable of producing modern complex antibodies. Other countries have been roaring ahead, building facilities to make these vital medicines, but not the UK. As a result, we have no resilience, we cannot guarantee our future supply chain. As the pandemic has vividly illustrated, when crisis hits, nations turn in on themselves and protect their own. We struggled at the beginning of the outbreak to source PPE and even some basic drugs.
That’s because there has long been a schism between the industry and the authorities, in the shape of the NHS and NICE, the body that effectively determines which medicines the health service should use, and MHRA, the one that regulates them.
The problem as the drug companies see it, is that we’re world class, as we’ve proved, where research is concerned, but when it comes to approving and using the medicines they’re discovering we lag behind. Our approval procedures have been slow and we haven’t liked committing the money in order to use them.
In the industry they call it “access and uptake”, and one lobbyist told me that where the UK is concerned it’s a “massive issue” for the companies. “Why would you manufacture a new, life-changing medicine in a country you know takes longer to approve and then use?”
Our actual market is small, so, having found the drug they quickly want to get on and use it, in the hope it’s approved and bought in bigger markets elsewhere. If we’re not prepared to make that second stage as smooth as possible they will simply choose somewhere that is more accommodating.
To speed things up, the government has launched the Innovative Licensing and Access Pathway (ILAP) via the MHRA. But that only extends so far. The proof will be in what happens next: will we actually approve and use the new medicines?
Pharma, because of the history, is understandably sceptical. Said the lobbyist: “Critically, the value NICE puts on life and the impact the medicine brings is much less than the pharma companies. Therefore, NICE pushes the price down before it approves a price list. Then, the NHS will seek to renegotiate the price again. Pharma feels NICE and/or NHS don’t truly value the new medicines and the difference they bring to patients and the NHS.”
When he was head of the ABPI, the UK pharma trade association, Erik Nordkamp, the former chief of Pfizer UK, wrote in 2018, that, “the global pharmaceutical industry needs Britain to do more as it weighs up whether to invest in Britain or go elsewhere.”
His sector employs more than 100,000 people in the UK and contributes substantially to our gross domestic product. But that’s mostly in R&D. Many extra jobs and revenue could be added if only the companies also manufactured in the UK as well – and our security of supplies would be much-improved.
“Focusing on research and development is not enough,” maintained Nordkamp. The process of getting new medicines approved and purchased in the UK was simply too slow. Nordkamp compiled a report with PwC that found it remained a significant barrier to UK investment for many global companies. “We surveyed US life sciences leaders and 98 per cent of them said that they prefer to invest in countries that are early adopters of new treatments.”
Added Nordkamp: “Three-quarters added that Britain’s position as a world leader is under threat because of a failure to get treatments to patients more quickly. Patients in France, Germany, Japan and Switzerland all benefit from 75 per cent more treatments in their first year after launch than are available in the UK. Just one-third of US executives consider the UK a top five market in life sciences.”
More must be done, he said. He singled out Belgium as a place to follow. “Britain should look to Belgium for a model of positive collaboration. There, the government-led life sciences strategy has resulted in the country achieving the EU’s highest levels of R&D expenditure per head, and the most medicines under development and clinical trials per head. In the past 25 years, the number of biotech companies in Belgium has risen from two to more than 120. The UK’s life sciences industry needs clear commitment from the government to join the top tier of countries for speed, adoption and use of cost-effective medicines and vaccines. The UK must cement its position in life sciences or risk the erosion of a critical industry.”
What’s occurred since then, of course, is the pandemic. We’ve got the vaccines. The authorities showed what can be achieved when they wish to and how quickly they can move. While it’s true that relative to the cost of other therapies vaccines are low, and you wonder what might have unfolded had they proved to be a lot more expensive, nevertheless the various bodies got behind them.
We’re also now facing an economy on its knees. Part of that recovery should include driving a bulldozer through old barriers. Joined-up thinking must be applied, to work more closely with our new best friends in big pharma, and to approve and use their products, and to build factories and create new jobs.