Only bold reform will expand access to innovative medicines in the UK

Without doubt, when we reflect on the many achievements of the UK healthcare system and our NHS, there is much to be proud of – but today we are faced with a paradox. We are living in a time where breakthrough science has the potential to transform treatment options for some of the toughest health conditions faced by patients in the UK. Yet the question is whether the system is currently set up to match the pace of innovation that science provides, so patients can fully benefit?

At Johnson & Johnson, our teams are continuously working to get ahead of the most complex diseases affecting patients and their families, but we know that these treatments only matter if patients can access them when they need them.

The last decade has seen a series of changes to the UK access environment for new medicines that have made it increasingly challenging for the NHS to deliver the innovative care that patients need.

Right now, just 56% of all new medicines approved by the European Medicines Agency (EMA) are available to patients in England and only 54% in Scotland. This compares with 88% in Germany and 77% in Italy.[i]    

Without bold reform, access to medicines will continue to stagnate in the UK, risking our position as a leading destination to do life sciences. We are already witnessing the impact. The government’s Office for Life Sciences charts that foreign direct investment in the UK life sciences sector more than halved between 2021 and 2023.[ii]

Now with a new government in place, we have an unparalleled opportunity to strengthen collaboration across the life sciences community, achieve our shared ambitions for the sector and truly deliver the best possible care for every patient in the UK.

The good news is that we have a strong recent precedent to draw upon. The UK’s COVID-19 vaccination programme showed what’s possible when political leaders, the pharmaceutical industry and health systems work together. By doing so, we were able to bring innovation directly into the hands of healthcare providers, deploy the nation’s resources more effectively and, most importantly of all, transform outcomes for patients.

The challenge now is to build on the lessons learned during the pandemic. Even the most pioneering drugs and therapies are only valuable if patients can actually be treated with them. Going forward, it is a certainty that UK policymakers must prioritise a shared vision and joint action to ensure the NHS can deliver “the best that modern science can offer”. [iii]

Bodies that assess new medicines for adoption by health systems, such as The National Institute for Health and Care Excellence (NICE) for NHS England, must strike a tricky balance. Appraisal frameworks need to be robust and inclusive while keeping pace with exciting scientific developments and evolving treatment pathways.

However, in my opinion, a recent review of NICE’s methods[iv] was a missed opportunity to incorporate more insight from the life sciences sector and introduce greater flexibility into the system. For one, severity modifiers were introduced. These enable adjustments to the thresholds at which medicines for particularly debilitating conditions are assessed. While these modifiers could benefit a wider range of patients, their rigid, formulaic criteria may unintentionally limit access to treatments for those with the most severe conditions.

To highlight another example, an increasing number of innovative medicines are effective across multiple rare diseases or cancers.[v] Unfortunately, the current criteria NHS England relies upon does not straightforwardly evaluate the differential value that such multi-indication medicines provide. If a clear and accessible route were established to include indication-based pricing, it could make it easier for these critical new medicines to be recommended for use and for more patients to receive their full benefit.

There’s real urgency when we’re talking about access to new medicines in the UK. Currently, just 25% of new oncology medicines approved by the EMA between 2019 and 2022 are fully available on the NHS in England.ⁱ This means that the most effective treatment may simply be unavailable for some patients, not due to its efficacy, but because of where they live.

Timely access to the right treatment does two things, it keeps people healthy and prevents disease worsening so they can participate in society and a thriving economy. It also impacts patient outcomes and reduces the likelihood of co-morbidity. As highlighted in the September 2024 Lord Darzi report, by improving access to care and addressing long-term sickness the NHS plays a role in driving national prosperity.[vi]

The recently announced Voluntary Scheme for Branded Medicine Pricing, Access and Growth (VPAG) Investment Programme is certainly a step in the right direction. Of the £400 million investment secured, 5% will focus on modernising the access environment.[vii] It will be critical for this investment to deliver meaningful change that ensures the UK avoids repeatedly falling behind when it comes to accessing the medicines of the future.

Over and above individual policy and regulatory changes, the path to lasting improvements in the access landscape lies with all parts of the life sciences ecosystem working together to fuel a virtuous cycle of innovation. Only by actively working together – government, healthcare providers and industry – can we create an environment that fosters innovation and, more importantly, brings its benefits to patients.

This year, ‎‎ ‎Johnson & Johnson proudly celebrated 100 years of operations in the UK. Our expertise has served as the foundation for decades of successful partnership with patients, healthcare providers, clinical researchers and the NHS. That’s why we wholeheartedly welcome the new government’s ambition to collaborate with the private sector on life sciences innovation. After all, healthy people build healthy societies and healthy economies.

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[i] EFPIA (2024). EPFIA Patients W.A.I.T. Indicator 2023 Survey. Available here: https://efpia.eu/media/vtapbere/efpia-patient-wait-indicator-2024.pdf. Accessed September 2024.

[ii] HM Government (2024). Life Sciences Competitiveness Indicators 2024: summary. Available here: https://www.gov.uk/government/publications/life-sciences-sector-data-2024/life-sciences-competitiveness-indicators-2024-summary. Accessed September 2024.

[iii] The Labour Party (2024). Labour’s Manifesto: Build an NHS fit for the future. Available here: https://labour.org.uk/change/build-an-nhs-fit-for-the-future/. Accessed September 2024.

[iv] NICE (2024). Public board meetings – NICE methods agenda board paper. Available here: https://www.nice.org.uk/get-involved/meetings-in-public/public-board-meetings/agenda-and-papers-march-2024. Accessed September 2024.

[v] Mestre-Ferrandiz, J., Towse, A., Dellamano, R. and Pistollato, M. (2015) Multi-indication Pricing: Pros, Cons and Applicability to the UK. OHE Seminar Briefing. Available here: https://www.ohe.org/publications/multi-indication-pricing-pros-cons-and-applicability-uk/. Accessed September 2024.

[vi] Lord Ari Darzi (2024). Independent Investigation of the National Health Service in England. Available here: https://assets.publishing.service.gov.uk/media/66e1b49e3b0c9e88544a0049/Lord-Darzi-Independent-Investigation-of-the-National-Health-Service-in-England.pdf. Accessed September 2024.

[vii] HM Government (2024). UK secures £400 million investment to boost clinical trials [Press release]. Available here: https://www.gov.uk/government/news/uk-secures-400-million-investment-to-boost-clinical-trials. Accessed September 2024.

CP-476396 | September 2024