The world’s biggest drug companies could reconsider their operations in the UK if the country’s new government doesn’t increase its spending on NHS treatments and patient access to new medicines, according to the Association of the British Pharmaceutical Industry (ABPI). The body’s manifesto, which laid out in detail how this extra money should be spent, also emphasises the importance of a new industrial strategy and cooperation with Europe.

The UK’s pharmaceutical industry is not only critical to the health of the country’s population but also to the success of its economy, investing billions of pounds in research and development and supporting hundreds of thousands of highly-skilled jobs.

Lack of funding

Yet, according to the ABPI’s new president Lisa Anson, if the UK’s new government continues to squeeze NHS funding and doesn’t take this opportunity to cement the country’s position as a global hub for the life sciences industry, it could face an exodus of drug firms and become “a desert for healthcare innovation”.

Speaking to The Times in April, Anson, who is also AstraZeneca’s UK president, said that drug companies would delay launching medicines in Britain if there wasn’t enough funding to approve them. She also suggested that without an increase in healthcare funding, companies would not be able to conduct clinical trials because they would not be able to assess potential new drugs against existing treatments if UK patients were not getting them in the first place.

By rationing healthcare spending, Britain is jeopardising its “research environment and access to new medicines by eroding the competitiveness of a key sector for a short-term affordability issue,” ABPI’s new president told the newspaper, adding that drug companies are “happy to discuss” possible tax increases to cover the cost of more NHS spending.

For Anson, the overriding question is: “Do we want to improve NHS patient outcomes and ensure Britain continues to be a global player in life sciences, or run the risk of the UK becoming a desert for healthcare innovation?” If the answer is the former, the ABPI has a three-fold solution.

Improving access to medicine

The first priority detailed in the ABPI’s General Election manifesto is to make patient outcomes in the NHS the best in the world, starting by increasing healthcare investment to the G7 average (11.3% of GDP), which would also bring it in line with historic levels. It would also ensure that the UK is in the top quartile of OECD countries for patient access to new cost-effective medicines and vaccines by 2022.

At present, the UK spends a total of 9.9% of its GDP on healthcare, which places it sixth of the G7 nations, only ahead of Italy, a situation which has led to patients in the UK not having access to cost-effective new treatments. Indeed, government analysis shows that, on average, for every 100 patients in comparable countries who get access to a new medicine in its first year of launch, just 18 patients in the UK receive the same.

“Supporting the NHS so it can embrace and invest in innovation is crucial to providing quality care to more patients within a sustainable budget,” says an ABPI spokesperson, adding that this will also mean that pharmaceutical companies will have the opportunity to forge even better, deeper collaborations with the NHS.

Securing a world-class NHS

Existing collaborations, such as the recently-agreed industry-NHS partnership across Greater Manchester, which is building on the success of the GSK-sponsored Salford Lung Study (the world’s first randomised controlled trial (RCT) that used a single electronic medical record linking primary care, secondary care and pharmacy data), demonstrate the potential of the NHS and industry working together.

Focused on real world evidence collection and the use of healthcare data, the collaboration created a Greater Manchester and Pharmaceutical Industry Partnership Group designed to use the unique data and information capabilities of the NHS to discover, develop and deliver new medicines and treatments for patients. It is also allowing Greater Manchester to explore new ways of paying for medicines based on patient outcomes – enabling the £1bn spent on medicines in the region to be as effective as possible.

Anson and the ABPI are calling for the government to increase the number of collaborative programmes, such as this one, including investing in infrastructure to enable the collection, access to and use of more real world data, as well as creating between two and four regional data hubs like Greater Manchester to attract clinical research and improve patients’ access to it.

Alongside this, the association supports the creation of a new long-term, voluntary Pharmaceutical Price Regulation Scheme (PPRS) in partnership with the pharma industry, balancing investment in new medicines, value for money for the NHS and the need to maintain a strong industry.

Putting pharma front and centre

The UK is currently recognised as the third largest life sciences cluster in the world, worth £30bn and comprised of over 5,500 companies directly employing around 140,000 people, who are twice as productive as the UK average. In order to keep it that way, and in the process attracting significant new international investment, the ABPI is also calling on the government to put the pharmaceutical industry at the heart of its economic policy.

According to the association, this should involve: increasing funding for basic science so that the UK reaches a target of 3% of GDP spend on research and development by 2022; attracting global scientists to the UK and encouraging the colocation of commercial discovery and development science; implementing an ‘end to end’ plan to build the pipeline of highly skilled research and innovation talent in the UK; improving the global competitiveness of UK medicines manufacturing; and ensuring the NHS is seen as a global early adopter of new cost-effective medicines and vaccines.

A new relationship with Europe

Finally, the importance of negotiating a new relationship with the European Union (EU), which secures patient access to medicines and public health and that can be implemented without disruption to patients, cannot be emphasised enough by the ABPI.

Not only should the new relationship achieve alignment between the UK and European regulatory frameworks, it should secure the ability to freely trade and move medicines and pharma supplies across borders and give the UK predictable access to funding and collaboration for scientific research.

As an ABPI spokesperson summarises: “The UK and European life sciences industry has regularly highlighted the importance of resolving the regulatory, supply and trading arrangements for medicines after the UK leaves the European Union, and the complexity involved in this process. Securing a deal to continue to collaborate on medicines regulation is the best way of ensuring that medicines continue to be developed and delivered to patients across Europe without disruption or delay.”

Open engagement with business

One of the keys to successfully implementing the steps laid out by the association, and thereby avoiding an exodus of pharmaceutical firms, will be communication between government and business. It’s a point that ABPI CEO Mike Thompson was keen to emphasise following the election.

“In the short-term, we take confidence in the Prime Minister opting for continuity in her Cabinet appointments and we would also like to see Number 10 follow through with their pre-election commitment to engage more openly, more proactively and more frequently with business,” Thompson said, adding that beyond taking a pragmatic approach to the real challenges Brexit presents to regulation, trade and access to talent, the ABPI will be looking for the government to bring forward an industrial strategy that builds upon the UK’s existing strengths.

“An effective Life Sciences Industrial Strategy will send a strong message that the UK is open for business and can help cement Britain’s position as a leading global hub for pharmaceuticals. Companies will want to see a clear plan for attracting inward investment; practical measures for developing highly-skilled jobs; and a strategy for improving NHS uptake of innovation, alongside better integration and use of health data.”