Medicines use in England has been increasing, particularly in the case of newer drugs, but the rate of increase varies substantially nationwide, according to the Long-Term Leadership Strategy report, published this week by the UK Ministerial Industry Strategy Group, a high-level group bringing together government and pharmaceutical industry representatives. Overall, this geographical variation in medicines use tends to be higher in secondary than primary care, and it reduces the longer a drug has been on the market.

In July 2005, the MISG, whose members include government ministers, officials and pharmaceutical industry leaders, agreed to develop the Strategy to look at improving relations between the National Health Service and industry to support the better use of cost-effective medicines. The report also includes recommendations for making improvements to both the European environment for the pharmaceutical industry through the European Commission’s High Level Pharmaceutical Forum, and to the regulatory environment for medicines.

Collaborative working: "mixed" experiences

While the MISG report acknowledges that past experience of joint NHS/industry working has been “mixed,” it adds that, where such projects worked well, there have been benefits for patients, the NHS and industry.

One such success for patients is the East Lincolnshire PCT Chronic Obstructive Pulmonary Disease (COPD) Programme, developed by the PCT in collaboration with GlaxoSmithKline, Boehringer Ingelheim and Pfizer. Through this initiative, patients with suspected COPD - who were previously referred to secondary care - are seen in primary care, with the hospital managing the most complex patients and specialist services. As a result, over a five-month period, for 78 out of 215 patients who had acute episodes, these were successfully managed at home.

UK “at a crossroads”

The MISG also sets out its Vision Paper, developed by a group of leading academics, patient groups, medical research charities, government officials and industry, which discusses how patient care can be improved through better use of new medicines. The Paper says that the UK is now “at an important crossroads. With a fine history of healthcare innovations and delivery, it now faces financing challenges as well as new and emergent research competitors on the global stage.” Moreover, it warns: “Its leading position is not assured.”

The group sees four key areas of opportunity:

1) Improving the environment for translational clinical research to create a more innovation- and research-friendly NHS that is then able to deliver better care for patients;

2) Developing the UK’s core competence to be a world-leading centre for measuring the impact of medicines when used in clinical practice;

3) Developing greater partnership between the NHS and healthcare regulators and industry to improve patient care and facilitate access to medicines; and

4) Empowering patients to provide them with greater opportunities to take control of their own health and provide input to medicine development and regulatory decision-making.

Launching the report, Department of Health Minister Lord Hunt said: “The pharmaceutical industry in the UK has discovered and developed more leading medicines than any other country apart from the USA and as much as the rest of Europe combined. The UK should lead the world in the development and delivery of long-term innovations in medicine, which maximise patient well-being while remaining cost-effective,” he added.

Dr Richard Barker, director general of the Association of the British Pharmaceutical Industry, said the industry welcomed this “new, collaborative approach to recognise the value of medicines in terms of their ability to prevent critical health events, rather than being treated as merely an item on the health budget. Patients can only benefit from these developments,” he said.

The MISG adds that the Strategy is also an important first step in the new development pathway advocated by Sir David Cooksey to increase the translation of health research into clinical practice for cost-effective medicines. Alongside Sir David’s recommendations, the MISG’s vision of what the UK environment for medicines should be like in 10 years’ time provides a direction for policy development in the coming decade, says the Group.

The catalyst for the MISG, which also meets twice yearly, was the March 2001 report of the UK's Pharmaceutical Industry Competitiveness Task Force. This called for a new high-level group to take forward the relationship between government and the pharmaceutical industry at a strategic level.

To read the Strategy, Click here . Updates on the Strategy will appear at this site throughout the year and the MISG will also report, by the end of 2008, on progress of implementation of the recommendations.