ABPI Scotland: Medicines in Scotland

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ABPI ScotlandMedicines in Scotland
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What is ABPI?

• Membership body of the Pharmaceutical Industry
  statutory negotiating body
• Represents majority of research based companies
• Members supply over 90 of medicines to the NHS
• 2/3rd of all research and development of new
  medicines is undertaken by member companies
• ABPI Code of Practice - administered by
• PMCPA
• http//www.pmcpa.org.uk/Pages/default.aspx

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Trust reputation?

• Declaration of payments
• Pads pens
• Clinical trial transparency
• Interaction with patient groups

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ABPI in Scotland

• Participation in National groups SMC, PASAG,
  PAPIG, LiSAB, Medical Directors group, Strategic
  Engagement Group, SIGN implementation group, NRS
  Industry partnership group
• 2 strategic groups SAVG, SLSG
• 9 Therapy specific groups
• Collaboration - gt A Common Understanding
• 2012 Working together for Patients

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Investment

• The pharmaceutical industry globally invests more
  in research and development than any other
  industry  12.1 million every day.
• The pharmaceutical industry employs around 25,000
  people in RD in the UK (Business Enterprise
  Research and Development (2008, 2009, 2010) 2010
  released Nov 2011 Office for National
  Statistics (ONS).

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(No Transcript)
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ABPI Key issues...

• Uptake and innovation
• Pricing is it a barrier to uptake?
• Clinical research are we under threat?

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ABPI Key issues...

• Uptake and innovation
• Low and slow

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Market share of innovative products in the UK is
behind European peers and deteriorating
Market share for products -brands and generics-
launched in the past 5 years by value ()(1)
Branded medicines launched in the past 5 years
are expected to account for 5 of spend only by
2015, similar to previous years levels
NICEs 40 rejection rate and NICE blight lead
to delays and limited access as well as poor
performance in innovation uptake(2)

1. IMS Health World Review Analyst, 2010
2. OHE analysis 2012

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Uptake of new medicines in Scotland (OHE stats)
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Uptake of new medicines in Scotland...

• Scottish Government recognised there is a
  problem
• CEL 17 (and follow-up CMO)
• Statement of Intent
• New medicines review (recently announced)
• Scottish Parliament has recognised there is a
  problem
• Public Petitions Committee inquiry
• Health Sport Committee Inquiry (ongoing)

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ABPI Key issues...

• Pricing is it a barrier to uptake?

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Overall, UK spending on medicines as a percentage
of GDP (developed countries)
Spending on medicines as a percentage of GDP in
various countries in 2011(1)
If Spain cut down pharmaceutical spend by 20,
the proportion of GDP would be 1.2, i.e. still
higher than in the UKs

• (1) IMS Health World Review Analyst 2012. OECD
  Health Database.  All data accessed March 2012

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The UK has severe uptake issues in critical
therapy areas
Spend per capita on cancer medicines launched in
the previous 5 years in Europe ()(1)

The UK has the lowest per capita spend in cancer
medicines launched in the past 5 years

• IMS Midas 2006

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Poor uptake of innovative medicines in the UK
leads to poor patient outcomes
5 year survival rates in cancer in Europe, men
and women ()(1)
The UK has the lowest survival rates in cancer in
Europe

• Eurocare 4 2009

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Branded pharmaceutical prices are amongst the
lowest in developed countries
Position of the UK in the ranking of branded
pharmaceutical prices by year(1)
2003 2003 2004 2004 2007 2007 2008 2008 2010 2010 2011 2011
USA 190 USA 176 USA 183 USA 252 USA 281 USA 331
Germany 102 Germany 106 Germany 113 Germany 142 Germany 155 Germany 153
UK 100 UK 100 Ireland 112 Ireland 134 Australia 139 Australia 143
Finland 98 Ireland 99 Sweden 105 Belgium 122 Ireland 133 Sweden 134
Austria 94 Finland 96 Belgium 101 Finland 119 Sweden 130 Belgium 123
Netherlands 93 Austria 94 UK 100 Sweden 116 Belgium 122 Ireland 123
Belgium 91 Netherlands 92 Finland 99 Netherlands 115 Austria 117 Netherlands 117
France 91 Belgium 90 Netherlands 99 Austria 111 Italy 113 Austria 115
Italy 90 Italy 90 Austria 96 Spain 109 Spain 106 France 104
Spain 81 France 84 Australia 94 France 108 Finland 105 Finland 103
Australia  - Spain 80 France 92 Italy 101 France 104 Italy 101
Ireland  - Australia  - Spain 88 UK 100 UK 100 Spain 101
Sweden  - Sweden  - Italy 83 Australia 94 Netherlands - UK 100
(1) OHE, 11th Report (2004-2010) 5th Report
(2000 - 2003) 2011 OHE calculations based on
IMS and PCA data. Note blank cell Not
available Notes Table includes the years prior
to PPRS negotiations (2003/2004 2007/2008) as
well as for 2010 and 2011 Exchange rate used
Average of Q4 of every year.
In a recent report (September 2012) The European
Commission has indicated that the UK is a highly
efficient medicines market
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The UK has among the highest penetration of and
use generics across European countries, c. 65
Generics market share in Europe by volume

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64
65
65
63
53
52
49
49
47
45
45
43
42
40
39
36
35
34
GR
BE
AT
CH
IT
IE
NO
ES
PT
FR
FI
TK
SE
NE
DK
CA
DE
UK
MEAN
NON GENERIC PRODUCTS
  GENERIC PRODUCTS
Source IMS 2012 (2011 data)
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In specific cases, medicines prices drop 90 in
price and 95 in volume in the first few years
after loss of exclusivity...
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Betweeen 2011 and 2015 (at list prices - OHE)...

• Total medicines bill for NHSScotland is projected
  to increase by 2.9 - 3.9 (1.37bn - 1.43bn)
• Branded medicines bill for NHSScotland is
  projected to increase by 0.5 - 1.5 (0.99bn
  1.03bn)

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Volume, not cost as the main driver of rise...?

• 100m front-line cuts for Scotlands NHSScotland
  in Sunday (Nov 25th 2012)
• ... On drugs and prescribing, NHS boards claimed
  many of the savings would accrue by switching
  from costly branded medicines to generic drugs,
  no longer covered by commercial patents.
• However, they also said reviews were being
  undertaken by GPs and hospitals to review the
  volume of prescriptions, the biggest cost driver
  in recent years.

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ABPI Key issues...

• Clinical research are we under threat?

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While the pharma sector contributes 1 in 2 RD
pounds in the UK(1), it is in decline
National origin of leading 100 global medicines
by sales 20042011 (2)
UK Global Share of patients in clinical trials
2000 2010(3)
-77
of global sales of leading 100 medicines by
country of origin
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2
1.4
2010
2006
2000
Twelve major pharmaceutical site closures between
1996 and 2012(4)

1. ONS UK Business Enterprise Research and
   Development, 2009
2. Department of Health, MISG, Pharmaceutical
   Industry Competitiveness and Performance
   Indicators 2009
3. Centre for Medicines Research (www.cmr.org)
   Global Clinical Performance Metrics Database
   Kinapse report
4. ABPI analysis

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The UK currently has a prominent position in
global launch sequences

• The UK is an early launch market in global
  pharmaceutical launch sequences
• 68 of pharmaceutical companies launch new
  medicines in the UK first (first, second or third
  market worldwide)
• 66 of companies anticipate that governments
  proposals for a new pricing scheme will adversely
  affect the UKs global position in the launch
  sequence

• Source Industry market research, Feb-March 2012

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Dont just take our word for it...

• Evidence given to the Health Sport Committee
  inquiry into new medicines from
• a group of 17 oncologists
• Oral evidence of a further oncologist
• Cancer Research UK
• The UKs lower rate of uptake for new cancer
  drugs may be damaging to our ability to design
  and run internationally competitive studies. If
  very few patients can get licensed drugs that are
  the standard of care outside the UK, this could
  lead to fewer industry-supported trials being
  conducted in the UK

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• The future

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The future

• Harder and more expensive to develop medicines
  no more blockbusters
• Personalised medicines
• Less money, more patients
• Health social care integration
• Long term conditions
• Move away from acute care

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The future

• Access to new medicines reviews
• Barriers to access?
• Closer collaboration and partnership working?

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• Thank you
• Keith Small ksmall_at_abpi.org.uk