Pharma and the ‘new’ NHS: Getting the most from partnerships

Leela Barham looks at the proposed reforms of the NHS in England and what they could mean for pharma’s approach to partnership



 

The ‘new’ NHS is going to be characterized by new relationships between the NHS and pharma, according to Shailen Rao, managing director of Soar Beyond, a specialist firm working on medicines management and service redesign in the NHS.

That’s because the reforms will place greater accountability for how NHS money is spent with GPs via GP commissioning consortia.

However, the entire process remains highly controversial and the final outcome—including the possibility of scrapping the reforms altogether, as some have called for—is still unknown.

If they go forward, the reforms will take place as the NHS needs to save an unprecedented £20 billion over the next four to five years.

This perfect storm of reform and budget cuts will “provide an opportunity for a rethink for both the NHS and pharma companies,” according to Rao.

“Commissioners will be able to be clearer about their need for care packages not packets of medicines. And companies, if they’re smart, will respond creatively.” 

This, he says, will create a more business-to-business model for the pharma industry.

Broader pathways

It will also mean companies need to be able to place their products into the broader pathway that commissioners will be concerned about—identification of patients, treatment and follow up, and compliance and adherence. 

That presents real opportunities, according to Rao, because “companies will be able to make a case about the value that they can bring to help the NHS across the whole pathway. Ultimately, that results in better outcomes, whether that’s for patients, the healthcare system, and value for taxpayer money.”

But companies, Rao notes, will need to navigate the legal and cultural challenges. 

Pharma must be mindful that it doesn’t fall foul of European legislation, such as that preventing direct-to-consumer advertising or the industry’s own code of conduct set out by the Association of the British Pharmaceutical Industry (ABPI). 

But, according to Rao, “companies can let commissioners set the parameters of the relationship and work within that.”

The ABPI notes that the ABPI code of practice provides guidance on joint working activities and there are tools to help companies work within the code through the Moving Beyond Sponsorship toolkit.

But it’s not just the pharma industry that may face hurdles; the NHS does, too.  

Rao sees real value in not just “selling a service to the NHS, but to help the NHS really deliver the service.”

So the challenge is to think flexibly about the challenges the NHS faces and what expertise a company may have to help overcome these, which could be something as simple as on the ground experience delivering services.

Wanted: More sophisticated reps

The move to a more business-to-business model will also require new ways of working within companies, according to Rao. 

“Companies will no longer need large numbers of sales reps,” he suggests.

“Instead, companies should invest in a slimmer workforce but one with more sophisticated skills.”

The right team will also need the right support, both from inside and outside the company, avoiding multiple layers of approval and, in some instances, working with intermediaries to help identify the win-wins for the company and the NHS.

Rao is confident that success will be measurable in a variety of ways. 

Patients will do better, and that will translate into less pressure on GP commissioning budgets in the future. 

The ABPI is also keen to point benefits like patients’ care taking place closer to home and fewer hospital admissions.

Pharma will benefit in terms of reputation and “through greater uptake of their medicines,” according to Rao, since greater uptake means greater revenue.

“Companies seeing the greatest uptake will be those that can align both their products and support services to the value agenda in the NHS,” he says. 

“It’s no longer about just getting clinical support for new medicines, but about ensuring that it delivers a measurable outcome that is also affordable and perceived as such by commissioners, who will have a different idea of what the outcome should be—realizable gains on real budgets in real time!” 

For more on the NHS reform process, join the sector’s other key players at Engage with the new NHS on September 27-28 in London.

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