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