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A few weeks ago, I enjoyed taking part in the Quintiles' webinar ‘UK Market Access Payer Perspectives'. I was joined by Dr Junaid Bajwa, GP and board member for Greenwich CCG, to discuss the value paradox in the UK market access space. The webinar brought the concept of 'value' and ways for biopharma and local health economies to work together locally out of the theoretical and into the real world, which of course is exactly where it needs to be.

The goal of overlapping values

Although we are all talking about aligning our values, it is important to be realistic. In an ideal world, industry and the NHS would be perfectly in sync, but in reality, that simply won't always be possible. It would be naive to think that commercial drivers and local care needs will always be completely aligned. 

From my own experience, we at Quintiles are sometimes asked by clients to engage with stakeholders where there simply is no overlap. On this, Dr Bajwa's position is clear: in such instances, the industry must be prepared to wait until commercial and NHS agendas overlap. And, he explained, a shift in perspective may be needed, away from the promotion and selling of a drug to a wider focus on the condition. 

The definition of market access 

Another point raised by Dr Bajwa is that good market access cannot purely be about 'accessing' the market, but about making a difference to patient outcomes. 

Of course, like any complex area, the term market access inevitably means different things to different people. For those responsible for marketing authorization, it could be defined as the EMEA filing for registration. For in-country health economists, it's the successful Health Technology Assessment process, or for brand managers and sales directors, it could range from pre-launch activity and formulary access, to any support programs that impact the patient pathway and appropriate use of the drug technology. The reality is that every one of these definitions is correct.  

The key to market access in my view, is ensuring there is funding available in a local health economy, and a strategy and operating plan is put in place to encourage appropriate use. An essential part of this must now be supporting local NHS health economies to improve outcomes for patients. 

The way forward: understanding a CCG's challenges 

If we are going to find the common ground between the NHS's aim for population health improvement, and biopharma's goal of getting a drug on formulary and used, I think there needs to be a shift in mindset. 

Dr Bajwa using his own CCG as an example, explained that both Greenwich's five-year strategy, and their Joint Strategic Needs Assessment setting out their public health agenda with the local authority, are all just a few clicks away on the internet. Biopharma companies should align their objectives with these long terms plans, if they want to pursue effective joint working in that particular location. But even if that isn't possible, each CCG also has QIPP (Quality, Innovation, Productivity and Prevention) challenges, and helping to address those is another opportunity for biopharma. 

These agendas are developed by local NHS stakeholders by looking at the very specific needs of their local population, which is why both he and I agree that perhaps the most powerful approach is to start with the needs of patients on the ground, and work back from there. This is something we are very focused on at Quintiles, from our outcomes audits to our patient support services, and despite our differences, it was clear from this webinar discussion that when we all focus on patient outcomes, we'll find that industry and payers will be able to collaborate successfully for the common good.


The second webinar in the series titled “UK payer perspectives: is big data the future for UK market access?” takes place on 5th November 2014 at 2-3pm.
Register for the free webinar and Q&A here.


This post is the fourth in an ongoing series on UK market access:

Topics in this blog post: CER, Market Access, NHS, Payers, EU, HTA