Growing complexity is playing havoc with innovation

Growing complexity is playing havoc with innovation

Originally published at Pharmafield

The Holy Grail for pharma
The Holy Grail for pharmaceutical companies is the ability to demonstrate which patients are likely to respond to innovative treatment, while ensuring timely access and uptake for them with appropriate reimbursement.


The problem is that health economies all other the world still cannot track cohorts of their patients across all pathways of care and collect the relevant real world data in order to examine if their treatment has been successful and, if it has, to what degree.

Therefore, it genuinely feels reasonable to ask whether it is the fault of pharmaceutical firms that they can’t always provide the data required for observational research. Whether it is actually always possible to make robust cases for their treatments when the most advanced, open and integrated health economies on the planet can’t either.

The reasonable answer to this is ‘not really’.

We could go further. Having to partner with, and essentially sell to, health economies is hard enough without having to keep abreast of multiple changes. Think about all of the things going on concurrently in the NHS; The Five Year Forward View (and Next Steps), Sustainability and Transformation Plans, Vanguards (including the new models of care and integrating health and social care), GP Federations, the Dalton Review, Carter Review, Naylor Review, Accelerated Access Review,  Better Care Fund, NHS RightCare, Parity of Esteem, Social Prescribing, Clinical Pharmacists in General Practice, channel shifts in Urgent and Emergency Care settings, Getting it Right First Time, place-based care, population health, self-care and so on. It’s a bewildering list and it’s not many of us can confidently explain them all.

Why list them? Well, the pharmaceutical industry is under incredible pressure to keep track of a moving feast while having to ‘beg, steal and borrow’ fragments of real world data to put together compelling cases for reimbursement. This situation doesn’t sound all that reasonable and that is why the failure of the Cancer Drugs Fund (CDF) stings so badly.

A recent review of the CDF, which cost £1.27bn from 2010 to 2016, concluded that it had been a huge waste of money. It was meant to provide patients with access to cancer drugs not available through the NHS, but was used most often for drugs that either did not report a statistically significant overall survival benefit in the index trials or had no overall survival data available when approved.

Worse still, the opportunity to collect valuable outcomes and quality of life data on what happened to patients benefiting from the CDF was missed completely. It’s jaw-dropping stuff.

There is a growing trend among health economies and healthcare professionals to view the life science industry as partners towards value-added healthcare, but expecting observational data to be presented if it isn’t being collected in the first place really isn’t reasonable. The wait for the Holy Grail continues.