Crystal Ball: Healthcare predictions ‘17

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2016 was a year of seismic shifts, but what does 2017 have in store for pharma and healthcare?

Having reflected on a tumultuous 2016 in the last issue, Pf has assembled a team of luminaries from across the NHS, industry and politics. They have been tasked with gazing into the 2017 healthcare crystal ball and sharing their predictions. Will we be dancing in the streets or hiding behind the sofa? Let’s find out…

 

 

Dr Charles Alessi, Senior Advisor, Public Health England

“2017 will be a year of turmoil for health and care in England. This will act as the spur for long awaited changes to implement a more locally-based delivery of care where local government and health are the important players and the person – not the patient – takes centre stage.”

 

 

Therapy areas and R&D

Chris Molloy, CEO Medicines Discovery Catapult

Patient charities hold the ‘long-term’ view, and that has helped fund continuing research into cancer, heart disease, Parkinson’s, Alzheimer’s and many others.

We are building a new model for discovery: disease–based syndicates, with patient research groups as the cornerstone. Engagement with their communities is critical to target selection, validation and proof of concept.

In an industry which takes over 10 years to bring products to market we should resist the temptation to continually refocus our R&D from one disease to another. Long-term global efforts in cancer have been needed to reach the current success in product flow and survival rates.

Quite rightly there has been a societal and scientific focus on dementia, helped by the excellent leadership and research focus of Alzheimer’s UK. Rates, however, may already be at a high watermark.

On a scientific level, if we are to take on the complexity of most non-orphan diseases we must look past the one-gene, one target, one medicine approach of old.

We remain horribly weak in the war on microbial disease. If the world does not invest, the UN foresees a $100 trillion impact on the global economy in the next 50 years – we are all at risk. There are economic barriers to overcome, but more worrying is the loss of expertise in the sector. A recent survey indicated the number of active, card-carrying experts worldwide may now be less than 2000.

An agreement at G20 on re-entry incentives will spark a renaissance in long-term funding, and the influx of money from the US will be a major step forward in 2017.

 

 

Ryan Wooller, Business Development Director, Star

“2017 will be the year of pharma understanding the game-changing nature of sustainability and transformation plans (STPs). Implications could pose both a threat and an opportunity for the pharma commercial model. Pharma supporting pathways of care could rise up the customer agenda.”

 

 

EU departure

Chris Molloy, CEO Medicines Discovery Catapult

Post-Brexit, 2017 will not offer the certainty that industry needs in terms of regulation or people movement. We should accept that situation and focus on things we can do – ensuring the UK remains a fertile place to discover and improve new medicines.

The UK has considerable public assets across academia and the NHS, and a financing hub that provides 30% of all European investment in biotech. It also has a strong, high-quality CRO community that can thrive in the modern ‘virtual’ discovery model.

Combining these capabilities is key to our industrial strategy in medicines and the significant increase in recent funding for InnovateUK. The £100M refilling of the Biomedical Catalyst provides the fuel.

  

Leslie Galloway, Chairman, Ethical Medicines Industry Group (EMIG)

We mustn’t judge the Government’s performance on a daily or weekly basis. Much of what is really happening will be behind closed doors and many compromises will be reached.

The messages that we need Government to receive are: 52% of people may have voted to leave the EU but many more, if asked, would have voted for a stronger economy that will support healthcare, education, law and order and living standards.

Having a vibrant economy is vital for any political party and the pharma industry should be at the forefront of any industrial strategy, because we don’t just deliver prosperity to the UK, we help deliver some of the best healthcare in the world.

We should retain as many of the benefits of EU membership as we can – the single market and access to the right people. We also need to focus on the opportunities that we can exploit with the Medicines and Healthcare Products Regulatory Agency and how we can become a global centre for research.

We have the opportunity to drop Corporation Tax to 10%, to attract international investment. If global companies are to invest in UK healthcare we need an NHS that is properly funded and a New Medicines Fund which delivers our new medicines to patients.

The UK – at 3% of the global market – may suddenly be perceived as a minnow and, if we have to develop a separate regulatory approval system, it could drop us down the ‘ladder’ of global pharma priorities.

 

 

Health and social care

Helen McKenna, Senior Policy Advisor, The King’s Fund

2017 promises to be a pivotal year for health and social care. NHS finances will continue to be a major concern – the Autumn Statement confirmed the NHS settlement set out in the last Spending Review, which means that 2017 will usher in three years of very little growth in the health budget.

Health leaders will be expected to get NHS performance back on track in 2017 – but this will be  tough. At the same time that budgets are squeezed, many NHS services are struggling to maintain their operational performance.

The latest NHS statistics show that services are under huge pressure and often failing to meet key targets, including the four–hour A&E and 18–week referral-to-treatment targets.

Demand for services keeps rising – the number of A&E attendances and emergency admissions to hospital are increasing rapidly. This increases the strain on services, with almost 11% of patients now spending more than four hours waiting in emergency departments. General practice, mental health and community services also remain under huge pressure.

There will be continuing calls on the government to identify a long–term solutions to social care funding. The social care sector is in a critical state – fewer people are able to access the care they need, delayed discharges from hospital are at record levels and there are deeply worrying warnings about the fragility of some large care providers. To find extra money, there will be a need to put social care funding on a sustainable footing for the future.

Although 2017 offers plenty of challenges, there are also some important opportunities. The new models of care being developed, in response to the NHS Five Year Forward View, along with the work being undertaken to deliver Sustainability and Transformation Plans, offer significant potential.

 

 

The political sphere

Alex Ledger, Deputy Managing Director at Decideum

2017 offers one unique opportunity for pharma – the chance for industry to work with Government to develop a new industrial strategy for Britain.

It goes without saying that Brexit has changed everything. The stakes have never been higher. The health of the UK economy is intrinsically linked to the success of its highly-skilled industry sectors and life sciences is the cornerstone of this, employing around 175,000 people, and with a £51bn turnover in 2015.

The UK wants to go toe-to-toe with the big US life sciences hubs in Boston and the Bay area on the West Coast. To do this – in a world unfettered by the regulations of the European Union – it must convince the global pharmaceutical industry that, in spite of potential barriers to accessing the European market, the UK offers unparalleled attractions, a world class research infrastructure and an innovation-open NHS, worthy of investment.

Q1 of 2017 will see a hive of activity on this strategy – coordinated jointly by the Secretaries of State for Health and for Business, and via the Office for Life Sciences. Indeed, some of this work is already underway and life sciences has been earmarked as one of the subjects which will form the Government’s overall post-Brexit plan.

Pharma has a rare chance to join together as an industry, look beyond marketplace competitiveness and provide the UK with the best prospect of competing independently on the global stage.

 

 

Robert Taylor, Head of Europe, Commercial Solutions, Quintiles IMS

“2017 will be a year of broadening the use of technology to support the sales process and the on–going emergence of the multichannel sales model. While the ‘human channel’ remains the cornerstone, interest in digital and remote engagement continues to grow, and demand for efficient commercial solutions which leverage different channels is increasing.” 

 

 

 

Primary care

Dr Anne Connolly, GP and Chair, Primary Care Women’s Health Forum

The main challenges will be coping with the fall out of local authority (LA) funding cuts. Delayed discharges, cancelled operations, higher emergency admissions and poorer community care are happening because of cuts in community placements, social support and staff in LA commissioned services, such as health visitors, school nurses and youth workers.

Other challenges include increasing demand and the poorer health of the population. Ageing and chronic long-term frailty problems, obesity and the link with metabolic syndrome, cardiovascular disease and cancers, mean that the self-care agenda will need to be prominent. There will be a push from GPs for patients to buy their own over-the-counter medicines and use online resources, pharmacists and other allied healthcare professionals before going to their GP or A&E.

All clinical commissioning groups are having to make cost efficiency savings, so more will want to make decisions about QIPP (Quality, Innovation, Productivity and Prevention) savings.

As GP practices develop into federations there will be a push for care closer to home, some care delivered by AQP (Any Qualified Provider) and better use of technology. The extended hours developments will need GP practices to work closer together to make sure that care can be delivered by primary care for longer hours.

Hospitals are under increasing pressure to reduce planned admissions and surgery as they struggle to cope with the extra unplanned and emergency work.

 

 

Peter Rutherford, Vice President Integrated Market Access, EMEA and Emerging Markets, Quintiles IMS

“2017 will be a year of increased focus on patient access requirements, as the need for scientific communications throughout the product lifecycle, and the numbers of complex new products requiring integrated patient support programs, continues to grow.”

 

 

The digital revolution

Dr Farzad Entikabi, GP and founder of Doctor Care Anywhere

The NHS is one of the most clinically advanced health services in the world, but the sector needs to implement innovation to find opportunities for improvement, as it faces the pressures of reduced budgets, rising demand and an ageing population.

Primary healthcare is one of the most strained areas of the NHS, with 60 million more consultations a year required compared to five years ago, and waiting times predicted to rise next year, from just under two weeks, to 17 days. Our recent research with YouGov found that due to the barriers of accessing a GP, 3.3million people have missed or put off seeing a GP, risking their longer–term health, and potentially costing the NHS more.

It is becoming clear that our primary healthcare services are stretched to breaking point and that, along with appropriate funding, innovation is also needed.

Technology – and specifically telehealth – is already offering solutions to these concerns, not only in terms of the diagnosis, monitoring and treatment of illnesses, but also in the way patients access healthcare. Indeed, 70% of GP appointments can be conducted via video or phone, and the next few years will see a significant change in how we access primary healthcare, with virtual GPs providing a quick, reliable and flexible healthcare service to a greater number of people.

Digital innovation is fuelling extraordinary developments in healthcare and will be a critical force in ensuring that existing health issues do not escalate into more significant problems.

 

 

Nick Lavery, Co–Founder & Managing Director, Republic M!

“2017 will be a year of growth for healthcare with continued market access pressure and greater competition. Return on investment will become increasingly important and the industry will accelerate adoption of innovative promotional and educational channels. This multi-channel approach will be integrated across the promotional mix to drive profitability.”

 

 

 

Clinical development

Divya Chadha Manek, Head of Business Development (Commercial), National Institute for Health Research (NIHR)

The NIHR Clinical Research Network predicts that the strapline for clinical development in 2017 will be ‘collaborate, collaborate, collaborate’.

2016 was a year dominated by mergers and acquisitions within the life sciences Industry. M&As are not a new thing within the sector, however, it is becoming apparent that for a company to be successful, there needs to be a shift in its approach to developing medicines for ‘tomorrow’s world’.

This move towards more open ways of working through strategic partnerships – spanning healthcare, academia, life sciences industry, the charitable sector and patient organisations – is gathering momentum. Mirroring the growing trend for outsourcing drug discovery, new and innovative collaborative models are emerging with the aim of accelerating medicines development.

Collaborations take many forms and bring many benefits. We are now seeing charities collaborating with the life sciences industry on multiple levels, allowing them to work in new ways and bring benefits to patients. Lab–based scientists and academics are coming together with clinical researchers, enabling them to share ideas and resources, driving forward drug discovery.

Similarly, life science companies are forming alliances with research delivery organisations and the NHS to optimise early phase testing of potential pharmaceutical products to expand their research and development programme.

Universities are joining forces to harness big data and find ways to support the safe use of patient data for medical research, while patient organisations are promoting initiatives to help finance generic drug trials for rare diseases.

The NIHR Clinical Research Network predicts more exciting collaborations. We often use the catch line: ‘The NHS is open for business’, but perhaps it’s time to say – ‘we are not just open for business, we are open for innovative approaches on how we do business.”