HDA Media And Political Bulletin – 19 May 2016

Average pharmacy will lose £19k over 10 months

18 May 2016, Chemist and Druggist, Beth Kennedy

 

The average pharmacy in England will lose £19,000 over the next 10 months as a result of funding cuts and the category M clawback, according to accountancy firm Silver Levene. The firm warned that small independent pharmacies will have a “tough time” and may struggle to stay afloat.

 

England’s chief pharmacist backtracks on hub and spoke safety

19 May 2016, Dispensing Doctors’ Association, Alisa Colquhoun

 

In a statement to MP’s, Dr Keith Ridge has admitted that the published safety data comparison with a large scale automated dispensing facility in Sweden was misleading. He will still push forward plans to boost hub and spoke dispensing, stating it “will improve safety and quality of patient care”.

 

Stevens: NICE process makes it ‘harder’ to strike deals with pharma

19 May 2016, Health Services Journal, Will Hazell

 

Last week NHS England’s chief executive, Mr Stevens, told the House of Commons public accounts committee that the Pharmaceutical Price Regulation Scheme, NICE appraisals and NHS England commissioning were “not interacting optimally”.  According to Mr Stevens, the requirement to commission NICE approved drugs leaves NHS England with less money to allocate to other potential treatments and makes it harder for them to negotiate down the price of expensive new drugs.

 

Healthcare professionals want transparency around fees received from pharmaceutical companies

18 May 2016, The Pharmaceutical Journal

 

According to a survey conducted by the ABPI, most healthcare professionals believe the details of payments they receive from the pharmaceutical industry should be made known to the public. The survey also highlighted that there are concerns that the information would be misinterpreted by the public.

 

ABPI, EFPIA and IFPMA issue joint statement following publication of the final report by the Review on AMR

19 May 2016, ABPI

 

The ABPI and the European Federation of Pharmaceutical Industries and Associations (EFPIA) and the International Federation of Pharmaceutical Manufactures (IFPMA) have issued a joint statement following the publication of the final report by the Review on Antimicrobial Resistance.  The statement praises the review, stating it has brought to the “world’s attention one of the greatest global health threats of our time”. It further states that the report marks the start of collaboration that must begin to address drug resistance and superbugs.

 

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England’s chief pharmacist backtracks on hub and spoke safety

19 May 2016, Dispensing Doctors’ Association, Alisa Colquhoun

 

England’s chief pharmaceutical officer has backtracked on the issue of hub and spoke safety.

 

In a statement to MPs, Dr Keith Ridge has admitted that the published safety data comparison with a large scale automated dispensing facility in Sweden was misleading and inappropriate. He explained that the dispensing model in Sweden – which uses medication ‘pouches’ – is not routine practice in the UK, and, furthermore, that the error rate quoted is a reported rate, and not observational.

 

However, the chief pharmacist will still push forward plans to boost hub and spoke dispensing in England. He said: “I remain of the view that automated centralised dispensing, underpinned by a robust quality assurance and regulatory system, resilient and implemented carefully, will improve safety and quality of patient care… if the UK implements and utilises relevant technology in a considered manner, including drawing on the experiences of other countries.”

 

 

Stevens: NICE process makes it ‘harder’ to strike deals with pharma

19 May 2016, Health Services Journal, Will Hazell

 

The NHS England chief executive said the health service had a “confusing set of mechanisms for choosing and reimbursing innovation”, which needed “aligning”.

 

Simon Stevens praised NICE’s ‘pragmatic’ approach to hepatitis C drugs

Last week Mr Stevens told the Commons public accounts committee that the pharmaceutical price regulation scheme, NICE appraisals and NHS England commissioning, were not “interacting optimally”.

 

Elaborating on the comments in an interview with HSJ, he said NICE’s approval of new treatments in specialised services – which NHS England is then obliged to fund – could have the effect of “pre-empting… what’s available for other parts of the specialised commissioning pipeline”. This is because the requirement to commission NICE approved drugs leaves NHS England with less money to allocate to other potential treatments.

 

It could also make it more difficult for NHS England to negotiate down the price of expensive new drugs, Mr Stevens argued.

 

Simon Stevens says NICE authorisation can make it “harder” to run a procurement for new drugs, because “implied price” set during appraisal

NHS England chief executive says PPRS, NICE appraisals and NHS England commissioning need “aligning”

 

Mr Stevens says inclusion of “affordability” in NICE process “a debate I expect we will have”

Authorisation of a drug by the National Institute for Health and Care Excellence can make it “harder” for NHS England to get a good deal from pharmaceutical companies, Simon Stevens has said.

 

The NHS England chief executive said the health service had a “confusing set of mechanisms for choosing and reimbursing innovation”, which needed “aligning”.

 

Last week Mr Stevens told the Commons public accounts committee that the pharmaceutical price regulation scheme, NICE appraisals and NHS England commissioning, were not “interacting optimally”.

 

Elaborating on the comments in an interview with HSJ, he said NICE’s approval of new treatments in specialised services – which NHS England is then obliged to fund – could have the effect of “pre-empting… what’s available for other parts of the specialised commissioning pipeline”. This is because the requirement to commission NICE approved drugs leaves NHS England with less money to allocate to other potential treatments.

 

It could also make it more difficult for NHS England to negotiate down the price of expensive new drugs, Mr Stevens argued.

 

“For those [drugs] covered by NICE appraisal, there is an argument that says that makes it harder to then run a competitive procurement process, when in effect the implied price has already been set through the appraisal,” he said.

 

Mr Stevens said the government’s “accelerated access review”, which is looking into improving uptake of medical innovations by the NHS, and which is due to be published after the EU referendum, would address some of these issues.

 

However, he said there would probably have to be further work to align what was a “confusing set of mechanisms for choosing and reimbursing innovation”.

 

The affordability of innovative drugs has achieved prominence recently with the introduction of new hepatitis C treatments.

 

NICE judged the drugs to be cost effective but they are expensive and represent a significant financial risk to NHS England.

 

When asked whether NICE should explicitly consider the “affordability” of new products as well as their cost effectiveness when making decisions, Mr Stevens said: “I’ve heard that argument made, particularly where the aggregate cost consequence in any year is above a certain threshold.”

 

“If you don’t do that then potentially you crowd out the uptake of other innovations in a particular period of time, so that’s a debate I expect we will have.”

 

Mr Stevens said NICE had “served us well since its creation”, and praised the “pragmatic” approach it had taken in giving NHS England flexibility to roll out the hepatitis C treatments on a “phased” basis.

 

He also said there was “more opportunity” for the NHS to “pull through” new products, particularly devices, using “commissioning for quality and innovation [payments] and other financial incentives”.

 

 

Healthcare professionals want transparency around fees received from pharmaceutical companies

18 May 2016, The Pharmaceutical Journal

 

Most healthcare professionals believe that details of payments they receive from the pharmaceutical industry should be made known to the public, but there are concerns that the information could be misinterpreted, according to the results of a survey conducted on behalf of the Association of the British Pharmaceutical Industry (ABPI).

 

Research consultancy ComRes interviewed 508 healthcare professionals, including 127 pharmacists, ahead of the launch of the ABPI’s publically available database that will contain details of fees made by pharmaceutical companies to healthcare professionals and financial details of drug company sponsorship of medical education.

 

Some 87% of interviewees agreed that payments they receive from the pharmaceutical industry should be transparent and 64% said the details should be publically available on a single searchable database. But 49% are worried that the data could be misinterpreted, 44% believe the public might look at the information in a negative light and 35% are worried it could trigger bad publicity.

 

The survey results also suggest that 15% of the healthcare professionals interviewed currently work with a pharmaceutical company and receive payment for their services (77 of the 508 interviewees) and, of those, 66% say that they have already given or are likely to give permission for payment information to be disclosed on the ABPI database.

 

The results of the survey, published on 17 May 2016, were revealed weeks before the ABPI is due to launch its database on 30 June 2016. The database’s launch follows the June 2012 decision by the European Federation of Pharmaceutical Industries and Associations — which represents the industry across Europe — that its members should disclose financial relationships with individual healthcare professionals and organisations by 2016.

 

The results of the ComRes survey were based on online interviews conducted between 15 March 2016 and 4 April 2016.

 

 

ABPI, EFPIA and IFPMA issue joint statement following publication of the final report by the Review on AMR

19 May 2016, ABPI

 

Click here to read the report.

 

“Lord O’Neill and the Review on Antimicrobial Resistance team have succeeded in bringing the world’s attention that resistance to antibiotics is one of the greatest global health threats of our time. We welcome the ambition for global action mapped out in the Final Report, and the call for political leadership, global coordination and diversity in local action, as well as pragmatism in highlighting a range of potential new systems to deliver a lasting sustainable solution.

 

The publication of the Final Report does not mark the end of the work, but rather the start of the collaboration that must now begin to address drug resistance and the rise of the superbug. Detecting, preventing and controlling resistance requires a strategic, coordinated, and sustained global and local response dependant on action from government, academia, the pharmaceutical industry, healthcare providers, patients, and the agricultural community. Keeping antibiotics effective is everybody’s responsibility.

 

The global pharmaceutical industry is already at the forefront of leading action to address antimicrobial resistance. In January this year, over 100 companies and 13 associations signed the Declaration by the Pharmaceutical, Biotechnology and Diagnostics industries on Combating Antimicrobial Resistance.

 

The Davos Declaration set out three key commitments. First, to reduce the development of drug resistance; second, to increase investment in R&D to meet global public health needs; and third, to improve access to high-quality antibiotics and vaccines for all. We also called on governments to commit to allocating the funds needed to create a sustainable and predictable market for these technologies while also implementing the measures needed to safeguard the effectiveness of antibiotics. There is a clear need for global coordination of stewardship, conservation, hygiene, and the creation and use of new commercial and incentive models for antibiotics, vaccines and diagnostics, to be delivered through local action.  We are pleased to see many of these objectives reflected and developed in the Final Report, and we welcome the collaboration called for by the Review team. Without collective action, we cannot expect real change.

 

Industry hasn’t been standing still with regard to developing new medicines to address drug resistance. There are currently 34 antibiotics and infection preventing vaccines in our global pipeline [2] and in 2014 alone the industry spent more than $137 billion collectively on all aspects of R&D [3], with 3.7% focused on anti-infectives. The investment, time and risk required by companies to discover and develop new antibiotics and vaccines needed for drug resistance is substantial and poses a unique challenge. For this reason, the industry has underscored the imperative need for a sustainable business model for these critical medicines, without which any interventions to develop new medicines will be limited.

 

We welcome the critical link the Review on AMR team has made between research investment and market based incentives to create a sustainable market that will deliver the next generation antibiotics and vaccines. Such push and pull incentives have already delivered success in other disease areas and must be used as a starting point for similar collaboration in antibiotics and vaccines to fund innovation on a global scale.

 

The report highlights existing initiatives such as the Biomedical Advanced Research and Development Authority [5] (BARDA) in the US, and the Innovative Medicines Initiative [6] (IMI) in Europe, the biggest life sciences public private partnership in the world, targeting bottlenecks in drug discovery to deliver new cures and new ways to tackle infectious and rare diseases. As part of IMI, New Drugs for Bad Bugs [7] a €696 million fund where industry directly contributes €345 million ‘in-kind’ has led the way in combating the scientific, regulatory, and business challenges that are hampering the development of new antibiotics. Comparable public and private funded initiatives on a global scale will be fundamental in this fight, yet the impetus this Final Report provides should also ensure that all local partners act now and commit to allocating funding and finding paths that work for their situation.

 

The Final Report covers several options to raise the funding required to tackle resistance, we will look at all of these options with a view to whether they are balanced, sustainable, likely to encourage investment into the area and encourage good science in the interests of patients. One of the options highlighted is a ‘pay or play’ payment levy on pharmaceutical companies to fund market entry rewards. The potential imposition of a tax on just one segment of the life sciences sector to fix a supply-side issue will significantly undermine current goodwill, cooperation, and the large voluntary investment and initiatives that are already underway. Ultimately, this approach may lead to less productive collaboration and innovation, and ignores the universal responsibility for finding a solution that all of society relies on. We need to be working towards incentives that support additional investment rather than punitive payments.

 

In an age of global austerity and the unique scientific, economic and environmental challenges presented by AMR, a new sustainable model that rewards innovation and shares the risk equally will be challenging to implement, but the overwhelming benefit of solving this problem requires all partners to now come together as equals and define the right set of proportionate and fair solutions.

 

The world is rightly impatient for a resolution to antibiotic resistance. Resistance undermines both our ability to fight infectious diseases and much of modern medicine, which has rarely faced such a grave threat. Only by working together can we deliver an effective and sustainable global response.”

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