What has Greater Manchester’s devolution achieved in terms of benefits to pharma’s market access activities?
It’s two years since Greater Manchester (GM) took control of its £6bn health and social care budget, following the deal struck in February 2015 to become the first English region to gain control of its health spending.
This immense devolution project involved 10 boroughs, 12 CCGs, and 15 NHS Trusts – with a budget of around £6bn. The aim of devolution was to better respond to local people’s needs, by using their experience to influence spending plans. According to the Greater Manchester Combined Authority, the result would be to ‘close the gap between those with the best health, and those with the worst’. But what did this mean for pharma?
Speaking at a webinar last year, Peter Rowe, Deputy Chairman of East Lancashire NHS Trust, said that the new environment had great potential benefits for industry: “Potentially GM could really be the test bed for things that you’ve wanted to do for years, which is to improve the value of your medicines, and prove the case that innovative use of medicines can make a difference to health outputs in the real world.”
The Greater Manchester devo team engaged with pharma companies by joining forces with the ABPI, EMIG and various other bodies in the pharma industry to sign a ‘Memorandum of Understanding’ (MOU), which would answer the many questions that industry had.
What is now happening on the ground in Greater Manchester, and how is it affecting pharma’s customer relationships and market access at a local level?
“All pharma, whatever their size, scale and specialty, have a real opportunity now”
What has been achieved so far?
James Roach, Managing Director, Conclusio Limited, is a firm believer in the need to open up a new and more impactful dialogue between the NHS and industry. He led the development of the business case and service strategies on Greater Manchester for integrated COPD and Hepatitis C elimination. He worked closely with industry partners and was able to see the first hand the positive impact that the ABPI and wider industry MOU had.
He noted that, in general terms, devolution has so far achieved:
- integrated delivery partnerships across pathways of care
- an ambitious focus on the wider determinants of health such as housing, education and commitment
- a political commitment to prevention and eradication
- improved health outcomes for the population
- more sustainable financially efficient service provision.
A seat at the table
Devolution positively affected pharma’s customer relationships at a local level, says James: “The main impact is positive and what we are effectively seeing is a commitment to transition the perception of pharma from supplier to partner,” says James. “There is a real recognition that beyond the product itself, pharma has speciality experience and expertise that can be a much-needed catalyst for change.”
James says that behind the rhetoric of the MOU, the partnership has true value. “This is not just warm words; all of this positive engagement and commitment by the industry MOU that was agreed with the ABPI gives the partnership status, provides industry with a seat at the table and binds the partnership in real terms.”
Engagement with pharma
The GM devolution team has engaged with pharma companies in a number of ways says James, including:
- mapping service provision and patient journey to understand constraints and delays in pathways of care, helping both commissioners and providers to maximise efficiency from funded services. This has been undertaken successfully in the Hep C Elimination programme in Greater Manchester
- focused education and training, in particular, upskilling clinical professionals and supporting them to optimise the benefits of therapy
- aligned project management resource
- provision of technology
- providing the real world evidence to support the longitudinal case for change
- pump priming IT innovation.
The GM devo project can also improve the value of a company’s medicines, as Peter Rowe predicted. “Education about the medicine and its impact can then lead to standardisation of good practice and improved outcomes for patients and the wider health and social care system,” explains James. “One example, in relation to COPD, has been the development of the Greater Manchester Medicines Management Group guidelines for COPD which will standardise the use of approved medications, supporting patients to manage their condition in community settings, improving their health outcomes and potentially saving commissioners circa £5 million per annum.”
This approach has an enormous benefit to market access activities, he adds: “This has the potential the change the dynamics of the relationship and give the pharma the opportunity to demonstrate its value ‘beyond the pill’, and its commitment to helping health and social care systems achieve their objectives. All pharma, whatever their size, scale and specialty, have a real opportunity now.”
Conclusio Ltd’s area of focus is developing integrated care systems and approaches across the NHS, working closely with industry on a number of levels.