SMC Evaluation Project The View From Industry

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SMC Evaluation ProjectThe View From Industry

• Martin Coombes
• Government Affairs Manager, AstraZeneca
• ABPI Representative SMC Evaluation Reference Group

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The Pharmaceutical Industry is recognised as a
key partner by SMC and have supported the
development of a robust and transparent
decision-making process.
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Life Science Message
Scottish Medicines Consortium Work
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SMC Evaluation Project

• Management Group Paul Catchpole
• Reference Group Martin Coombes, Jim Swift
  Andrew McGuigan
• ABPI Scotland Andy Powrie-Smith
• SMC User Group Forum

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SMC Evaluation Project

• Stakeholder engagement
• Medicines utilisation
• Not recommended
• Accepted for use/restricted use
• SMC advice on unique treatment
• Evaluation of Budget Impact

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Stakeholder Engagement

• Evolving process
• Industry seen as partner
• Continue to increase communication
• SMC process well recognised, timely,
  straightforward
• Consistent advice, but varying NHS Board
  processes and application, which would benefit
  from greater transparency
• Reduce duplication NICE/AWMSG
• More proactive patient involvement

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Medicines Utilisation
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Medicines Utilisation

• Not recommended

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Medicines Utilisation

• Not recommended
• 10 medicines remained not recommended 0.1 of the
  primary care spend 2005/6
• Not added to formulary
• No means No

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Medicines Utilisation

• Not recommended
• Delay of SMC advice
• Limited use relative to alternative treatments
• No alternative licensed products
• Influence of pharmaceutical industry marketing
  strategy
• Variation in advice issued by national bodies
• Lack of engagement of relevant clinical experts
  in early stages of SMC

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Medicines Utilisation

• Accepted

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Medicines Utilisation

• Accepted/Restricted Use
• Data limitations
• Where alternative treatments already exist,
  implementation of advice is subject to local NHS
  Board decision making
• Acceptable variation?
• Yes means Maybe

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Unique Treatment

• Etanercept for psoriatic arthritis
• HDL (2003) 60
• No clean and relevant dataset
• No single Scottish centre to collate data
• Issues around local organisation structure

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Budget Impact

• Variable
• Actual vs Budget Impact
• From 3.2m to -11.9m
• Multiple issues
• Derivation unclear, Trial drop-out rates,
  Restricted Use, lack of uptake
• Compare actual uptake vs BI
• Between NHS Boards
• Other countries

Forward Look SMC Budget Impact
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Key Conclusions

• Evolving and improving
• Engagement
• More Pt group contact Industry communication
• Need greater understanding of local NHS Board
  processes To provide consistency, transparency
  and accessibility
• Medicines Utilisation
• Data? Variation in uptake?
• When does yes mean yes?
• Regular monitoring of uptake (compare with other
  countries)
• Budget Impact
• Robust
• Actual vs Budget Impact

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