News

HDA UK Media And Political Bulletin – 27 February 2017

Media Summary

Drug Shortages: Manufacturer Accountability Increasing

Pharmacy Times, Dylan Girardi, 23 February 2017

Drug shortages provoke risky adjustments to medical regimens, and epidemiologic data collected in Canada since the early 2000s shows a rise in shortages. While causes are easier to understand, the consequences are more complex, affected by incomplete disclosure of drug shortages, difficulties in determining inventories in real-time, and difficulties associating shortages with clinical outcomes in the population. Mandatory reporting is not sufficient to solve the drug shortage problem. Researchers recommend that hospitals create committees to identify drug shortages, and that pharmacies must review their inventory management policies to safeguard a buffer in case of shortages.

ABPI – New partnership set to help ‘transform’ access to medicines for patients in Greater Manchester

ABPI, 24 February 2017

An agreement enabling Greater Manchester to explore new ways of paying for medicines based on patient outcomes will help the city meet its goal to be the safest and most effective place to receive medicines in the world. Multiple proposals with the potential to improve care for people in Greater Manchester are currently being discussed under the MOU and some are already underway. Greater Manchester has already started a diabetes programme with a number of pharmaceutical companies and an asthma study is underway, with discussions about four other potential studies also taking place.

Britain eyes American drug approval pact

The Times, Peter Evans, 26 February 2017

A committee of MPs, industry bosses and trade bodies has examined linking part of the UK’s approval process for medicines with the US Food &Drug Administration (FDA) after Britain leaves the European Union, according to people close to the talks. This option was first discussed as a contingency plan by David Cameron’s government before the EU referendum and is still seen as a viable alternative to a deal with the EMA. Another option, considered more moderate, would be for Britain to run the Medicines and Healthcare products Regulatory Agency as a sovereign drug approval body that adopts some of the decisions by the FDA and some by the EMA.

Stevens and PM warned over ‘bickering’ about funding

HSJ, James Illman, 27 February 2017

The high-profile disputes between Theresa May and Simon Stevens over NHS funding has been criticized by the public accounts committee for undermining public confidence in the service. Committee chair Meg Hillier demanded an “honest, grown-up conversation about future [of the NHS]” for taxpayers. The Financial Sustainability of the NHS report warned that measures to restore financial stability were affecting patients’ access to services and damaging the overall system. Recommendations included that the Department of Health, NHS England and NHS Improvement should set out a recovery plan by March 2017 which targets those NHS bodies and health economies in severe financial difficulty.

Parliamentary Coverage

There is no Parliamentary Coverage.

Full Coverage

Drug Shortages: Manufacturer Accountability Increasing

Pharmacy Times, Dylan Girardi, 23 February 2017

All over the world, drug shortages cause complex and risky adjustments to medical regimens.  While epidemiologic data tracking shortages has only been collected since the early 2000s, the trend shows a definite increase in incidence. Shortages stem from a variety of causes including:

•             Manufacturing difficulties

•             Raw materials shortage

•             Recalls

•             Natural disasters

•             Business/economic pressures

The causes are well understood, but little research documents the consequences of drug shortages. Understanding how patients, providers, and health systems are affected by drug shortages can be complicated by:

•             Incomplete disclosure of drug shortages

•             Difficulties in determining inventories in real-time

•             Difficulties associating shortages with clinical outcomes in a population

A research group from Montreal, Quebec, Canada has studied drug shortages since 2006. In Canada, more than 1000 drugs may be affected within a single year, and most shortages last 4-5 months. In the same year, the FDA reported just 210 shortages here in the United States—although comparisons are difficult due to variable definitions of the word shortage.

In the United States and Canada, cardiovascular drugs account for 1 of the top 5 drug-class shortages. Resulting adjustments cause suboptimal drug selection, increased labor cost, errors, and poor outcomes including death.

Previous attempts to increase transparency have been unsuccessful due to voluntary reporting of data by manufacturers. New Canadian legislation requires manufacturers to give advanced notice of shortages—like in the United States—starting in 2017.

But mandatory reporting alone is not expected to solve the drug shortage problem. Researchers are calling on clinicians and government organizations to make manufacturers more accountable for drug availability and adaptation during shortages.

They recommend that hospitals create a multidisciplinary committee with a mandate to identify drug shortages and create action plans. They urge clinicians to collect and publish more data on incidents related to drug shortages so that we may understand their impact on patients better.

The researchers conclude that pharmacies must review their inventory management policies to ensure a safe buffer in case of shortages.

ABPI – New partnership set to help ‘transform’ access to medicines for patients in Greater Manchester

ABPI, 24 February 2017

A unique partnership announced today by the pharmaceutical industry and Greater Manchester Health and Social Care Partnership will help the city region deliver its vision to be the safest and most effective place to receive medicines in the world – and cement its position on the global research and development map.

​​​​​​​The collaboration, in the form of a Memorandum of Understanding, will create a Greater Manchester and Pharmaceutical Industry Partnership Group. The group will improve the use and safety of medicines and use the unique data and information capabilities of the NHS to discover, develop, and deliver new medicines and treatments for patients.

The agreement will allow Greater Manchester to explore new ways of paying for medicines based on patient outcomes – enabling the £1 billion spent on medicines in the region to be as effective as possible.

And it sets out how industry will partner with Greater Manchester to enable the development of a world-leading site for the research and launch of new medicines.

It will be formally launched on the same day 14 multinational companies come to Manchester at a global industry seminar, an event which reflects the city region’s aspiration to be a key international location for the growth of jobs and investment in the thriving life sciences industry, rivalling the ‘golden triangle’ of Cambridge, Oxford and London.

Jon Rouse is Chief Officer of Greater Manchester Health and Social Care Partnership.  He said:

“Our ambition is to be the safest and most effective place to receive medicines in the world and this unique step will help us on that journey. We want to be able to improve people’s health, get the very best value for money from our medicines budget and continue to raise Greater Manchester’s profile as a global hub for investment in research and development.

“The agreement is a first step; there are some important principles we will observe and much still to be done but it shows the power of collaboration we’re harnessing in Greater Manchester. When we come together then we can really grasp the opportunities devolution has given us.”

Mike Thompson, CEO of the Association of the British Pharmaceutical Industry, said:

“The Pharmaceutical Industry is proud to be signing this Memorandum of Understanding with Greater Manchester. The Industry recognises the challenges faced by the NHS and we are

committed to supporting improvements in the use of medicines that can enhance the care and wellbeing of people in the area.

“We can see from initiatives like the Salford Lung Study how the NHS can embrace innovation to help improve health outcomes.  In Greater Manchester we have the infrastructure in place to go even further and create one of the world’s pre-eminent hubs for life sciences research and investment from global companies.   By working together with the NHS to improve how to use and learn from real time health data in hospitals and communities we have the best chance of creating the most appropriate and cost-effective medicines for patients in Greater Manchester and throughout the UK.”

Rowena Burns Chair of Health Innovation Manchester said: “Our goal is to improve the health of Greater Manchester citizens by working more effectively with industry. This MOU represents a brilliant first step toward this goal, and sets out our commitment to work with the pharmaceutical industry to deliver new medicines to patients more quickly, to make more effective use of existing medicines, and to increase the number of real world clinical trials in Greater Manchester, which will benefit patients and bring additional economic benefits to the region.

“We are delighted that the ABPI shares our ambition, and recognises the regions exceptional academic and clinical assets and our emerging world class informatics infrastructure.  Together we can make a real difference to the health of our patient population.”

The Memorandum will be signed between at today’s meeting of Greater Manchester Health and Social Care Strategic Partnership Board by a number of partners: Greater Manchester Health and Social Care Partnership (the Partnership), Greater Manchester Combined Authority, Health Innovation Manchester, the Association of the British Pharmaceutical Industry (ABPI), Ethical Medicines Industry Group (EMIG), and the British Generic Manufacturers Association (BGMA).

 

The report added that from April 2018 CCGs will enable the “transfer of activities from CCGs to the new care models from April 2018” and “the establishment of a single integrated CCGs team from April 2018 to be able to fully implement new accountable care arrangements from April 2019”.

In July last year Paul Maubach, chief officer for Dudley CCG, took on the top job at Walsall CCG in addition, after the latter was placed into financial special measures by NHS England.

The Black Country STP footprint currently has four main acute providers – Royal Wolverhampton Trust, Sandwell and West Birmingham Hospitals Trust, Dudley Group Foundation Trust and Walsall Healthcare Trust. The latter three are partners of the Black Country Alliance, a joint venture partnership formed in 2015, while there are also separate local provider integration projects under way across the patch.

Stevens and PM warned over ‘bickering’ about funding

HSJ, James Illman, 27 February 2017

The high profile “bickering” between Theresa May and Simon Stevens over NHS funding is an “insult to tax payers” and undermines public confidence in the service, the public accounts committee has warned.

The MPs delivered the blunt message to the NHS England chief executive, the prime minister and other relevant system leaders in its latest report on NHS finances, which warned the current ”sticking-plaster approach is not sustainable”.

Committee chair Meg Hillier demanded an “honest, grown-up conversation about future [of the NHS]” for taxpayers and warned that only by working together would the NHS and government be able to address the health service’s “significant challenge”.

The Financial sustainability of the NHS report also raised concerns that repeated “crisis driven raids on [capital] funds” to prop up revenue spending could “result in ill equipped and inefficient hospitals”. It also said measures taken to restore financial stability were “affecting patients’ access to services and overall experience”.

A further concern raised was that local NHS organisations were being asked to deliver plans which were not “really achievable” and that the Department of Health and NHS system leaders did not understand how realistic their own plans were.

Ms Hillier said: “Contradictory statements about funding from the prime minister and head of NHS England are an insult to taxpayers who deserve an honest, grown-up conversation about future finance and service provision.”

“Government’s rigid adherence to a set of stock lines about funding, in the face of mounting evidence its plan isn’t up to the job, is not it.”

She added: “This sticking-plaster approach is not sustainable, will not enable the NHS to get ahead of the problems it faces, and represents neither good value to taxpayers nor the best interests of patients.”

Recommendations

  • The Department, NHS England and NHS Improvement should publish an assessment of whether there is the “capacity in NHS bodies to deliver everything they are expected to within the agreed timeframes” by March 2017.
  • DH, NHS England and NHS Improvement should set out a recovery plan by March 2017 which targets those NHS bodies and health economies in severe financial difficulty.
  • DH and NHS England should report back to PAC by July 2017 on what they have done to understand the association between financial performance and the impact on patient care.
  • DH and NHS England should assess and publish findings by July 2017 on the impact that financial pressure in social care is having on the NHS, “so that it can better understand the nature of the problem and how it can be managed”.
  • DH, NHS England and NHS Improvement should review and improve national and local planning for capital expenditure to “call a halt to crisis driven transfers out of capital budgets to meet day to day revenue spending, which is not good value for the taxpayer or the future of the estate”.

In its analysis of the 44 sustainability and transformation plan footprints, due by the end of March 2017, NHS England and NHS Improvement should set out how they will support organisations to deliver real transformation in the areas where plans fall short. “They also need to convince the public of the benefits of the plans to them.”

The committee’s evidence session for this report held last month began with Mr Stevens hitting back at criticism of his approach and his “unenthusiastic” attitude towards making savings by Downing Street sources.

Mr Stevens expressed his irritation and stated for the first time in public that he believed the NHS had received “less than we asked for” to fund the Five Year Forward View.

This contradicted the insistence by the prime minister and other ministers such as health minister Jeremy Hunt that the government has fully funding the NHS England blueprint.

HDA UK Media And Political Bulletin – 27 February 2017

From Factory to Pharmacy

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