Hot Topics

Pharmaceutical Sales Managers Group

January 2007

David Fisher

Commercial Director ABPI

Hot Topics

Office of Fair Trading Market Study

Distribution

Health Select Committee enquiry into NICE

Ministerial Industry Strategy Group

Organisation structureDr Richard BarkerDirector General

Dr Richard BarkerDirector General

Dr Richard TinerDirector of Medicine

Dr Richard TinerDirector of Medicine

Nicky LilliottDirector of Regulatory Affairs

Nicky LilliottDirector of Regulatory Affairs

David FisherCommercial Director

David FisherCommercial Director

Paul EvansFinance Director

Paul EvansFinance Director

Dr Philip WrightDirector of Science & Technology

Dr Philip WrightDirector of Science & Technology

Carol WilsonLegal DirectorCarol Wilson

Legal Director

Ben HayesDirector of Public Affairs

Ben HayesDirector of Public Affairs

Prof Adrian TowseDirector Office Health Economics

Prof Adrian TowseDirector Office Health Economics

Natacha Deschamps-SmithPolicy and Project Manager

ABPI Board of Management

PMCPA

The ABPI’s 7 Objectives

Improved access to and of medicines uptake Increased patient engagement The Code and the PMCPA….retain self regulation Pricing and reimbursement ….The PPRS and the OFT MHRA and Better Regulation Improving the technology base in UK Enhance the reputation of the Industry

OFT: Does PPRS meet its objectives?

– Secure the provision of safe and effective medicines for the NHS at reasonable prices

– Promote a strong and profitable pharmaceutical industry capable of such sustained research and development expenditure as should lead to the future availability of new and improved medicines

– Encourage the efficient and competitive development and supply of medicines to pharmaceutical markets in this and other countries

OFT : ABPI Interactions

Series of meetings throughout 2006 Three substantial written submissions

OFT briefings on Feb22nd Publication in advance of this date?

Outcome?

Potential OFT Outcome??

Value based pricing concept Pricing linked to the “value” of an individual medicine Market entry….pricing linked to HTA? More attention to comparative prices of in-market

products?

90 Day public consultation period

PS…..National Audit office

Typical approach is to highlight potential savings from changes in prescribing patterns

Report due April ABPI in dialogue, input to draft report

Opportunity….Rx efficiency vs Rx effectiveness

“ Eli Lilly set to shake up UK drugs distribution…”Times 14/12/06

“ AZ plan for delivery of medicines triggers protest….”Times 13/12/06

Quarterly reporting of product sales at list and net

Disclosure of margin

DH concerned about “effect on public purse”

Distribution Changes

Opportunities and Threats?

A matter for individual companies Unlikely to be “one size fits all” Direct relationship with purchaser

NICE: Health Select Committee

Focal point for Industry proposals Multiple stakeholders Probably differing views across Industry Access Strategy Group to coordinate ABPI/Industry

Position

NICE/HTA: Some major themes

Significant negative reaction from patient groups to recent appraisals….patient power!

QALY…a precise science? Manufacturers not included in appraisal hearings Variable work output from External Review Groups Appeal Process unsatisfactory

No means No……Yes means Maybe!

Ministerial Industry Strategy Group

Long Term Leadership Strategy

Better Regulation Medicines Uptake Partnership Europe

• Government support for NHS/Industry partnerships

•Diagnosis and proposals to address low/variable uptake of new medicines

LTLS - Timeframe

Progress Report to MISG – 9 February 2006– Work Programme for 2006 Agreed

Progress on Europe and Regulatory Groups – 18 May 2006

Final Report to MISG – 1 November 2006

Publication February 2007

“Post Code Lottery”• Inequitable access to medicines/treatments

•Political and Medical problem

•Three HTA systems magnifies problem

•UK lags behind continental Europe in uptake

•Industry NHS “Partnerships” offer some solutions

Long Term Conditions are a principal driver of healthcare cost

Disease Area National Prevalence 2005/2006

Asthma 5.8 per cent

Cancer 0.7 per cent

Chronic Obstructive Pulmonary Disease 1.4 per cent

Coronary Heart Disease 3.6 per cent

Diabetes 3.6 per cent

Epilepsy 0.6 per cent

Hypertension 12.0 per cent

Hypothyroidism 2.4 per cent

Left Ventricular Dysfunction 0.4 per cent

Mental Health 0.6 per cent

Stroke 1.6 per cent The Information Centre, NHS

Unplanned and expensive inpatient episodes

Pharmaceuticals are part of the solution to better long term condition management

In all the above areas, pharmaceutical research has resulted in – New treatments for control or reversal– New formulations for easier/faster administration,

better compliance – Improved tolerance, fewer complications

Implications for salesforces

Actual prevalence of disease

No contact with system

In contact but no related complaint investigated

Complaint investigated but not correctly diagnosed

Diagnosed but untreated

Treated but not optimally

Treated optimally

100%

Public Health Programmes

‘Find and treat targets’

incentives

Diagnostic tools Therapy decision

support

More qualified clinicians

NICE guidance reinforced

‘Find and Treat’ Programmes could make a major impact

Implications for fieldforces

Flexibility in resourcing

Collaborate AND Compete

Source of knowledge and skill (not just money!)

The patient must benefit

In Summary

Longer Term Industry/Government relationships give room for optimism

Short term environment likely to become more negative

More pressure to demonstrate value for money of medicines

Questions and discussion

Pharmaceutical Sales Managers Group

January 2007

David Fisher

Commercial Director ABPI

dfisher@abpi.org.uk