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The ABPI NHS Outreach Programme Update for Wellard's King's Fund Meeting 22 March 2007. Martin Anderson ABPI Director, NHS Policy & Partnerships. The Curate’s Egg. Bishop “I’m afraid you’ve got a bad egg, Mr. Jones”. Curate “Oh, no, my Lord, I assure you that parts of it are excellent!”.
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The ABPI NHS Outreach Programme Update for Wellard's King's Fund Meeting 22 March 2007 Martin Anderson ABPI Director, NHS Policy & Partnerships
The Curate’s Egg Bishop “I’m afraid you’ve got a bad egg, Mr. Jones” Curate “Oh, no, my Lord, I assure you that parts of it are excellent!” Punch for 9 November 1895
NHS Task Force Members cont….
Mission Statement “the overall aim of the NHS task force is to build relationships with key stakeholders in order to optimise the environment for the appropriate use of innovative medicines to the benefit of patients”.
NHS and PHARMACEUTICAL INDUSTRY WORKING TOGETHER for PATIENTS 2005 Edition Supported by: • NAPC • NHS Alliance • NHS Confederation
Learnings……… • All of the ‘difficult to access’ PCTs that have been visited (or spoken to) wish to work with pharma • They all struggle to communicate their strategic agenda / clinical ‘needs’ effectively to pharma • They do not have sufficient resource to establish effective relationships with the large number of companies that approach them on an ‘ad hoc’ basis
Learnings………. • They do not want pharmaceutical sales representatives ‘detailing’ them (as they do GPs) • Many have ‘banned’ pharmaceutical sales representatives from the PCT as there is little / no value in seeing them • ‘Medicines Management’ teams, usually led by Pharmaceutical Advisors, are hostile to pharma as they “distort local decision making” processes
WIGAN LIFT Wrsley Mesnes WIGAN LIFT Worsley Mesnes
Life Expectancy at Birth2001-2003 • Large inequalities in health (and health care) between G.M. and England and within GM • Lowest Life Expectancy at Birth in England for men and women (still) • CHD and Cancer are main causes, increasing contribution from alcohol misuse
Working with Ashton Leigh & Wigan PCT • developing their ‘learning network’ to deliver high quality continuing professional development to their clinical and managerial staff • Ensuring contributions from pharma are valued and recognised • Improving access and dialogue for companies in this ‘difficult’ PCT
Governance • Joint PCT/ABPI Project Board - Reports to PEC and ABPI NHS Task Force • Development of Curriculum • Engagement of Pharmacos • Rules of Engagement • Define Success Criteria • Monitor Progress • Ensure Rules of Engagement are adhered to
Funding ABPI / PCT - 50/50 Funding Project Manager Not asking Pharmacos directly for money – expertise and other resource Led to the ALWPCT / ABPI Diabetes ‘Find and Treat’ Project
The ABPI NHS Out – ReachProposals • To take and share the learnings from ALW (and Nottingham City PCT) with other PCTs and Pharma Co’s • To develop an ABPI virtual presence in 3 regions in England (North, Central and South) • To work with local HDMs to improve the quality and quantity of interaction between the local NHS and pharma
Objectives of NHS Outreach Programme • To establish a minimum of 9 joint working projects in agreed locations and to learn from the experience so as to enable more joint working opportunities in 2008 and beyond • To articulate the benefits for all parties and share and communicate these with local and head office personnel (both pharma and NHS) • To identify, and present solutions, to the challenges which arise from joint working
Outreach Programme well received by Industry Over 110 Industry Executives will have attended initial 3 Regional meetings Region Meeting Date Industry Attendees/Apologies Trent / East Midland 22nd May 44 North West 23rd May 41 South West 13th July 27 Total 112
Company Participation (Attendees) Trent Pfizer Solvay Roche Altana Takeda Amdipharm Fresenius Thornton Ross Sankyo Galderma Cephalon Leo Eisai Ivax Amgen Abbott Napp Norgine Boehringer Lilly Sanofi-Aventis Alchemy Schering Merck Astra Zeneca Novo
Company Participation (Attendees) North West Novartis Lilly BMS Napp Solvay Sanofi - Aventis Astra Zeneca Norgine Amgen Wyeth Takeda Roche Pfizer Trinity Merck Boehringer Eisai GSK Altana Janssen Leo
Company Participation (Attendees) Southwest Wyeth Boehringer Takeda Astra Zeneca Trinity - Chiesi Novartis Eisai Pfizer Sanofi – Aventis Napp Amgen Roche Abbott GSK Leo Recordati MSD Janssen Solvay
Initial Industry Meeting • Facilitated by Pharma Partners Ltd. • Attended by ABPI. • Described process and programme objectives. • Obtained buy in from Industry Executives. • Identified ‘problem’ PCTs, each of whom (32) invited to meet Pharma Partners.
Early experience highlights necessity of programme • Strongly welcomed by Industry on ground • Access already gained and dialogue possible with problem PCTs • Pharma Partners acting as facilitator between PCTs and Industry • Pharma Partners identifying: • New PCT management and attitudes. • New PCT priorities. • Opportunities in new PCTs. • Pharma Partners translating PCT priorities into more attractive • partnership projects for industry.
Feedback from Difficult to Access PCTs • Do not see company visits as a good use of time • Companies not attuned to needs and objectives of PCT. • Interested in selling one product. • Pick brains of PCT executives. • Too busy. • Will approach companies they wish to deal with. • HDMs are not always HDMs. • Want to see senior people. • Occasional bad experience but generally not anti Industry. • Willing to work with Pharma Partners as a neutral facilitator. • No negative response to Outreach Project.
Lessons learnt so far • Need (top down) blessing in companies • Get appropriate Industry representation • Does not respond to normal ROI criteria • Problem PCTs will respond to rightneutralapproach • Pharma Partners to help problem PCTs translate their objectives into possible partnership opportunities which are attractive to Industry • Communicate, Communicate, Communicate programme
Lessons learnt so far (cont) • Champions • Partnership ‘templates’ (governance etc) • Funding arrangements • 10 step ‘how to’ guide • Fit for purpose?
NHS Outreach Project: Summary • Underway in 3 identified regions. • Priority problem PCTs identified in each region. • Pharma Partners has met the large majority of the (32) DTA • PCTs. • 8 projects already identified. • Next meeting with Industry groups scheduled. • Hard Work!!
Long Term Leadership Strategy (LTLS) 3 work streams • Partnership Working Group • European Working Group (input to High Level Pharmaceutical Forum – pricing, relative effectiveness and patient information) • Regulatory Working Group (improving the process for medicines registration and for post license approval monitoring of medicines)
Partnership Working Group Objectives • To examine and propose action on how the industry can support the NHS in implementing NHS policies, improving health outcomes and productivity, including the management of long-term condition • To examine and propose actions to embed the embracing of pharmaceutical company innovation (products, services) in the NHS; this would include improving the uptake of new medicines in the UK, including the implementation of NICE guidance • To develop a framework for relationships and joint working between the NHS and industry
Initial Focus • Uptake of new medicines: • Why is UK uptake low? • Agreement on measures to address • Partnership working: • What is currently happening? • What works/does not work and why? • Recommendations for future areas of joint working • Cultural issues – market research to identify: • What they are • Similarities and differences • Attitudes to innovation
What is ‘joint working’ (partnership) Joint working between the NHS and Pharma refers to situations where, for the benefit of patients, organisations poor skills, experiences and / or resources for the joint development and implementation of patient centred projects, and share a commitment to successful delivery. Joint working agreements and management arrangements are conducted in an open and transparent manner.
Outputs (2007) • Guidance from DH on joint working for the NHS • A best practice toolkit • Ongoing training for both the NHS/pharma to encourage mutual understanding, trust and cooperation
Communicate, Communicate, Communicate • Letters to all (77) member company CEO’s . • Letters to all (77) ‘Healthcare Policy’ Heads in companies. • Letters to all (32) problem PCT CEO’s. • Pharma Times / HSJ article. • NAPC / NHS Alliance conference presentations. • Numerous presentations to pharma audiences. • Dedicated ABPI extranet site. • Re-launch in May?
The Alternative Curate’s Egg Bishop “So you have a completely good egg?” Curate “Oh, no my Lord, parts are still off, but let’s hope we stop it spreading.” ABPI Cymru Wales – Oct 2005