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ABPI Scotland: Medicines in Scotland
ABPI Scotland:Medicines in Scotland
•Membership body of the Pharmaceutical Industry – statutory negotiating body
•Represents majority of research based companies
•Members supply over 90% of medicines to the NHS
•2/3rd of all research and development of new medicines is undertaken by member companies
•ABPI Code of Practice - administered by
PMCPA
http://www.pmcpa.org.uk/Pages/default.aspx
What is ABPI?
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• Declaration of payments
• Pads & pens
• Clinical trial transparency
• Interaction with patient groups
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Trust & reputation?
•Participation in National groups – SMC, PASAG, PAPIG, LiSAB, Medical Directors group, Strategic Engagement Group, SIGN implementation group, NRS Industry partnership group
•2 strategic groups – SAVG, SLSG
•9 Therapy specific groups
•Collaboration - > A Common Understanding
2012 – Working together for Patients
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ABPI in Scotland
•The pharmaceutical industry globally invests more in research and development than any other industry – £12.1 million every day.
•The pharmaceutical industry employs around 25,000 people in R&D in the UK (Business Enterprise Research and Development (2008, 2009, 2010) 2010 released Nov 2011 – Office for National Statistics (ONS).
Investment
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•Uptake and innovation
•Pricing: is it a barrier to uptake?
•Clinical research: are we under threat?
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ABPI: Key issues...
•Uptake and innovation
– Low and slow
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ABPI: Key issues...
Market share of innovative products in the UK is behind European peers and deteriorating
(1) IMS Health World Review Analyst, 2010 (2) OHE analysis 2012
Market share for products -brands and generics- launched in the past 5 years by value (%)(1)
NICE’s ~40% rejection rate and NICE ‘blight’ lead to delays and limited access as well as poor performance in innovation uptake(2)
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Branded medicines launched in the past 5 years are expected to account for 5% of spend only by 2015, similar to previous
years’ levels
Uptake of new medicines in Scotland (OHE stats)
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Scottish Government recognised there is a problem:
o CEL 17 (and follow-up CMO)
o Statement of Intent
o New medicines review (recently announced)
Scottish Parliament has recognised there is a problem:
o Public Petitions Committee inquiry
o Health & Sport Committee Inquiry (ongoing)
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Uptake of new medicines in Scotland...
•Pricing: is it a barrier to uptake?
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ABPI: Key issues...
Overall, UK spending on medicines as a percentage of GDP (developed countries)…
(1) IMS Health World Review Analyst 2012. OECD Health Database. All data accessed March 2012
Spending on medicines as a percentage of GDP in various countries in 2011(1)
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If Spain cut down pharmaceutical spend by 20%, the proportion of GDP would be 1.2%, i.e. still higher than in the
UK’s
The UK has severe uptake issues in critical therapy areas
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The UK has the lowest per capita spend in cancer medicines launched in the past 5 years
(1) IMS Midas 2006
£
Spend per capita on cancer medicines launched in the previous 5 years in Europe (£)(1)
Poor uptake of innovative medicines in the UK leads to poor patient outcomes
15The UK has the lowest survival rates in cancer in Europe
(1)Eurocare 4 2009
5 year survival rates in cancer in Europe, men and women (%)(1)
Branded pharmaceutical prices are amongst the lowest in developed countries
2003 2004 2007 2008 2010 2011USA 190 USA 176 USA 183 USA 252 USA 281 USA 331
Germany 102 Germany 106 Germany 113 Germany 142 Germany 155 Germany 153
UK 100 UK 100 Ireland 112 Ireland 134 Australia 139 Australia 143
Finland 98 Ireland 99 Sweden 105 Belgium 122 Ireland 133 Sweden 134
Austria 94 Finland 96 Belgium 101 Finland 119 Sweden 130 Belgium 123
Netherlands 93 Austria 94 UK 100 Sweden 116 Belgium 122 Ireland 123
Belgium 91 Netherlands 92 Finland 99 Netherlands 115 Austria 117 Netherlands 117
France 91 Belgium 90 Netherlands 99 Austria 111 Italy 113 Austria 115
Italy 90 Italy 90 Austria 96 Spain 109 Spain 106 France 104
Spain 81 France 84 Australia 94 France 108 Finland 105 Finland 103
Australia - Spain 80 France 92 Italy 101 France 104 Italy 101
Ireland - Australia - Spain 88 UK 100 UK 100 Spain 101
Sweden - Sweden - Italy 83 Australia 94 Netherlands - UK 100
(1) OHE, 11th Report (2004-2010); 5th Report (2000 - 2003); 2011: OHE calculations based on IMS and PCA data. Note: blank cell = Not availableNotes: Table includes the years prior to PPRS negotiations (2003/2004; 2007/2008) as well as for 2010 and 2011Exchange rate used: Average of Q4 of every year.
Position of the UK in the ranking of branded pharmaceutical prices by year(1)
16In a recent report (September 2012) The European Commission has indicated that the
UK is a highly efficient medicines market
The UK has among the highest penetration of and use generics across European countries, c. 65%
Source: IMS 2012 (2011 data)
Generics market share in Europe by volume
%
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51%
34% 35% 35% 36% 37%47% 48% 51% 53% 55% 55% 57% 58% 60% 61% 64% 65% 66%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
GR
34%
BE
35%
AT
36%
CH
39%
IT
40%
IE
42%
NO
43%
ES
45%
PT
45%
FR
47%
FI
49%
TK
52%
SE
53%
NE
63%
DK
64%
CA
65%
DE
65%
UK
66%
MEAN
49%
% GENERIC PRODUCTS
% NON GENERIC PRODUCTS
•Total medicines bill for NHSScotland is projected to increase by 2.9% - 3.9% (£1.37bn - £1.43bn)
•Branded medicines bill for NHSScotland is projected to increase by 0.5% - 1.5% (£0.99bn – £1.03bn)
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Betweeen 2011 and 2015 (at list prices -
OHE)...
•£100m front-line cuts for Scotland’s NHSScotland in Sunday (Nov 25th 2012)
•“... On drugs and prescribing, NHS boards claimed many of the savings would accrue by switching from costly branded medicines to generic drugs, no longer covered by commercial patents.
“However, they also said reviews were being undertaken by GPs and hospitals to review the volume of prescriptions, the biggest cost driver in recent years.”
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Volume, not cost as the main driver of rise...?
•Clinical research: are we under threat?
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ABPI: Key issues...
While the pharma sector contributes 1 in 2 R&D pounds in the UK(1), it is in decline
% o
f g
lob
al s
ales
of
lead
ing
100
m
edic
ines
by
cou
ntr
y o
f o
rig
in
National origin of leading 100 global medicines by sales 2004–2011 (2)
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Twelve major pharmaceutical site closures between 1996 and 2012(4)
(1) ONS UK Business Enterprise Research and Development, 2009(2) Department of Health, MISG, Pharmaceutical Industry: Competitiveness and Performance Indicators 2009(3) Centre for Medicines Research (www.cmr.org); Global Clinical Performance Metrics Database; Kinapse report(4) ABPI analysis
UK Global Share of patients in clinical trials 2000 – 2010(3)
0%
1%
2%
3%
4%
5%
6%
7%
8%
2010
1.4%
20062000
6%
2%
-77%
The UK currently has a prominent position in global launch sequences
• The UK is an early launch market in global pharmaceutical launch sequences
• 68% of pharmaceutical companies launch new medicines in the UK first (first, second or third market worldwide)
• 66% of companies anticipate that government’s proposals for a new pricing scheme will adversely affect the UK’s global position in the launch sequence
Source: Industry market research, Feb-March 2012
•Evidence given to the Health & Sport Committee inquiry into new medicines from:
–a group of 17 oncologists–Oral evidence of a further oncologist–Cancer Research UK:
“The UK’s lower rate of uptake for new cancer drugs may be damaging to our ability to design and run internationally competitive studies. If very few patients can get licensed drugs that are the standard of care outside the UK, this could lead to fewer industry-supported trials being conducted in the UK”
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Don’t just take our word for it...
The future…
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•Harder and more expensive to develop medicines – no more blockbusters…
•Personalised medicines…
•Less money, more patients…
–Health & social care integration
–Long term conditions
–Move away from acute care
The future…
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•Access to new medicines reviews…
–Barriers to access?
•Closer collaboration and partnership working…?
The future…
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