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UK pharma pledges to ensure new price deal boosts medicine access and innovation


The chief executive of the UK's pharma trade body has said it will work with the government to ensure the new five-year pricing deal improves patients' access to the latest medicines and boosts innovation, during 2014.

Stephen Whitehead, who heads the Association of the British Pharmaceutical Industry (ABPI), told APM that top level meetings with government were already under way to ensure key features of the deal were implemented.

He said he is mainly satisfied with the outcome of pricing negotiations between the UK government and industry, which led to a new Pharmaceutical Price Regulation Scheme (PPRS) coming into force at the beginning of the month.

In a phone interview, Whitehead said he is meeting this month with health secretary Jeremy Hunt and David Nicholson, the outgoing chief executive of the National Health Service (NHS) in England, and he will attempt to ensure the deal fulfils industry's stated goals of greater access to UK patients for medicines as well as maintaining NHS list prices.

The ABPI is keen that list prices are not eroded - even if the drugs are later discounted or rebates are made - to avoid a knock on effect in other European countries that may reference the UK price in setting their own.

European pharma has long complained about an eternal downward pricing spiral of countries referencing low-price markets and then reducing their own prices.

Whitehead made his comments as the ABPI prepares this month to publish data from its National Metrics Report which, he says, will raise concerns about usage and uptake of NICE-recommended medicines by the NHS.

A separate report, also due to be published later this month, will evaluate the success of the UK government's life sciences strategy, which is a key part of its plan to boost economic growth.

Whitehead told APM the deal has left the ABPI with three major tasks in 2014. Firstly it must work with the UK health ministry to monitor as tightly as possible UK drugs sales given the rebate agreed under the PPRS.

This latest PPRS includes an absolute NHS drug spend limit above which pharma must refund the balance. This year's ceiling is in the region of 12 billion pounds according to consultation documents released ahead of the deal being signed.

A second concern of the ABPI's is ensuring that the rebate, which is paid to the NHS if it overspends on drugs above a pre-determined limit, reaches NHS hospitals and organisations and is not held back in central funds.

The rebate system is intended to ensure NHS organisations feel confident using new drugs by removing the risk that they will go over-budget. But the ABPI is worried this confidence will be eroded if any repayments for overspend do not go back to the body which overspent.

Whitehead said the rebate scheme could remove the "affordability risk" for NHS organisations making decisions on whether to fund new drugs.

This will prevent the need for regional cost-effectiveness bodies that can further limit access to new drugs in England, he argued.

The ABPI thirdly hopes to work with NICE, which will soon begin consulting on new cost effectiveness assessments, to ensure it is more "pro-innovation", said Whitehead.

NICE is to begin consulting on its value-based assessments, which will likely take into account social benefits of drugs and issues such as burden of disease on patients, with a consultation on the new methodology scheduled to begin early in 2014.

According to Whitehead, the institute is currently ill-prepared to assess drugs that have been approved on Phase II or potentially earlier data - which will become increasingly common as they are targeted at narrow indications in subgroups of patients within a disease.

He said: "There are issues with NICE in terms of the risks it is prepared to take. NICE has not looked at this sort of data to make its decisions and a lot more drugs are coming through targeted at areas of high unmet need."

In the interview, Whitehead added that he is pleased that proposals to introduce value-based pricing have been scrapped because of the low prices the scheme would have created, although he said he was disappointed that small businesses will also be subject to the rebates.

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