Accelerating access to treatment and markets

Source: NHE Sep/Oct 17

Hilary Newiss, chair of National Voices, on the latest significant developments of the Accelerated Access Review (AAR) from her perspective as patient champion.

There is some cause for optimism when it comes to implementation of the AAR. 

This autumn we can expect the government’s plan to take forward the recommendations, and we have already seen concrete action. In July, government minister Lord O’Shaughnessy announced up to £86m to support innovators and the NHS in overcoming barriers to getting new, innovative technologies to patients. The funding is a welcome first step towards delivering on the AAR plans. 

Other work is ongoing to build the voice of people and patients into the priority setting for new treatments, and to make the repurposing of drugs more straightforward. 

The National Institute for Health Research is now consulting on best practice for including patients and citizens in all aspects of research and innovation. The need for involvement at every stage of research and innovation was set out in National Voices’ work for the AAR. 

Accelerating or restricting? 

Earlier this year, National Voices convened a workshop of charities and advocacy groups, alongside officials from the Office for Life Sciences. The aim of the meeting was to highlight priority areas for the implementation of the AAR recommendations. However, the discussion was dominated by wider issues of access to treatments and services. 

The positive noises from government on speeding up access to treatment come at a time when measures are being taken to reduce access to services in other areas. For example, the relaxation of the 18-week referral to treatment targets, a consultation on guidance to stop prescribing certain treatments, including those available over the counter, and attempts to avoid paying for specific treatments, such as Pre-exposure prophylaxis (PrEP). You can argue the rights or wrongs of each decision, but taken as a whole, they imply a system restricting access, not accelerating it. 

Of most concern to the national charities at the workshop was the NICE and NHS England decision to implement a new ‘budget impact test’ for new treatments. The new test would mean that roll-out of NICE-approved treatments expected to cost more than £20m in any one of their first three years of use could be delayed for up to three years, or in some cases even longer. 

Many of these measures appear contrary to the notion of accelerating access. 

The benefits of accelerating access 

So how to make sense of these two apparently competing forces? 

When I joined the AAR group in summer 2015 as patient champion, Brexit was not on my mind. In fact, I don’t think I had ever used the word. 

Fast-forward two years and the implementation of the AAR recommendations is increasingly couched in terms of Brexit. Much of the thinking about realising the AAR appears to be focusing on supporting life sciences as part of shaping a post-Brexit economy for the UK. 

The importance of the life sciences industry to the national economy was emphasised by Sir John Bell in his Life Sciences Industrial  Strategy recommendations to government, published in August. Making the UK an attractive place to do business is a reasonable aim, but it is not the only benefit of accelerating access to treatments. 

Improved access to medicines and treatments has the potential to significantly improve the lives of people in the UK. It also has the potential to make the country a more attractive place for the developers of such medicines and treatments, with knock-on benefits for the economy. These benefits are not mutually exclusive; both can be achieved. 

The government must not fall into the trap of seeing the Accelerating Access agenda as solely an issue for the economy. They must retain a focus on the prize of speeding up the roll-out of medicines and treatments that patients and citizens want and need. In doing so, they can improve the lives of people and patients. The aim is to accelerate patients’ access to treatment, as well as companies’ access to markets.




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