One big theme in the UK’s Life Science Industrial Strategy report is developing more collaboration between the NHS and the pharma industry. Abi Millar looks into how this might work in practice.
When UK’s Life Science Industrial Strategy was published at the end of August, its recommendations were met with widespread approval. The government-commissioned report, authored by the immunologist and geneticist Sir John Bell, lays out practical ways that the life sciences sector can maintain its ‘world-leading’ status after Brexit.
Described as an ‘impressive document’ by the Association of the British Pharmaceutical Industry, an ‘ambitious vision’ by Wellcome and a ‘blueprint to improve health outcomes’ by Genomics England, the report is above all timely – a workable set of proposals during a challenging period for the UK.
“The UK has an outstanding track record in biomedical and health research, arguably the best in the world,” says Sir Professor Robert Lechler, president of the Academy of Medical Sciences. “As soon as the government announced it wanted to have an industrial strategy, back in January, people like me felt life sciences has to be a prominent part of that because it’s a sector in which we perform really well.”
For the purposes of this report, the life sciences sector covers the pharmaceutical, biotech and medical devices industries, which together have an annual turnover of £64bn. It directly employs more than 233,000 scientists and staff, includes around 500 companies, and invests more in R&D than any other UK sector.
A dense report
Perhaps unsurprisingly, the Strategy runs to a densely packed 75 pages. It takes a broad view on life sciences, exploring topics from discovery science right the way through to manufacturing.
One of its key proposals is the creation of a Health Advanced Research Programme (Harp), which will bridge the gap between private and public funding. Essentially a coalition of government, charity and industry funders, it will invest in large research infrastructure projects and high-risk ‘moonshot programmes’, which will ultimately create two or three entirely new industries within healthcare.
The report also suggests increasing R&D spending, taking action to address skills shortages, increasing the number of clinical trials and providing better support for UK manufacturing. On top of that, it reiterates support for the Accelerated Access Review, an independent inquiry that explores how the NHS can be quicker to adopt innovations.
While there is a lot to parse, one common theme to emerge is collaboration –specifically, bringing the NHS and industry closer together.
“We are trying to shift the nature of the interaction between the industry and the Department of Health from being essentially confrontational to one where they can work constructively together,” said Sir John Bell in an interview.
Collaboration is key
So what might it mean in practice for the NHS to be more closely involved with industry, and why is that such a desirable goal?
As Lechler explains, the NHS holds great promise as a tool for research and innovation. There are several reasons why this potential hasn’t been realised to date.
“One very familiar aspect of the problem is that the NHS is struggling to sustain its required performance within its current resource envelope,” he explains. “Under those circumstances it’s difficult for NHS consultants to fit in time for research. Another problem is that the NHS is intrinsically conservative, and so the readiness to adopt novel things is perhaps not as high as one would like. I think we need in some way to incentivise adoption.”
The Life Sciences Industrial Strategy could go some way towards alleviating these issues. It calls on the NHS to engage in 50 collaborative programmes with industry over the next five years, such as late-stage clinical trials, real-world data collection, or the evaluation of diagnostics and devices. These could take the form of shared-risk programmes that produce a reward to the NHS along with a sustainable return to industry.
“We’re already beginning to see more risk sharing between commercial partners and NHS adopters,” points out Lechler. “The report mentions Medtronic, which has successfully persuaded a number of NHS Hospital Trusts to start to using novel devices. They will share the risk, in the sense that if this doesn’t save money in the long run they’ll share the cost. That’s quite a radical approach and it’d be good to see more of that.”
Data and clusters
The report also talks extensively about NHS data, which it calls ‘one of the most important resources held by the UK health system’. Among other recommendations, it suggests creating regional ‘digital innovation hubs’ that would hold data for several million people and could be used for clinical research.
“We need to have a really mature public dialogue on the use of data, and why it’s so important that people agree for their data to be used in clinical research,” says Lechler. “We also need to become more efficient at creating data lakes in quite large populations. I’m optimistic we’ll see that progressing.”
Another way to increase collaboration might be via life sciences clusters, which are typically based around a university and include elements of NHS infrastructure. The report explains that, while governments rarely seed such clusters, they play a key role in supporting their growth.
Lechler says that, when discussing collaboration, academia is an underlooked piece of the puzzle. A truly ‘three dimensional’ partnership will include academic research scientists, on top of the NHS and life sciences companies.
“We all have the same fundamental goal, which is improving clinical outcomes and population health, but we bring different skills and assets to that table,” he explains. “The industry itself has a number of key skills, but they’re complementary to the skills that exist in the academic sector, and it all depends on access to patients. So I’m a very strong believer in clusters, which are a coming together of those three sectors to work in real partnership.”
With these kinds of partnerships, patients will typically be involved at an earlier stage of the drug development process. This in turn means knowing more quickly whether or not you want to proceed, saving time and money along the way.
The next steps
Lechler says he concurs with many other aspects of the report, especially its support for discovery science and business development. He also welcomes its emphasis on skills, given the issues that Brexit is causing with retention and recruitment.
Regarding the Harp fund, he believes there needs to be some continuing discussion about the kinds of ‘moonshot’ projects the UK should be taking on.
“I’m very supportive of taking on some bold challenges, but we need further discussion about the level of risk we’re prepared to accept and the amount of money we’re prepared to throw at it,” he says. “And with the Accelerated Access Review, I hope we will see some real action on implementing its recommendations, especially having a mechanism to identify novel and transformative new agents and therapies and then fast-tracking them into clinical use.”
While the strategy itself is not binding, the government has said it is engaging with Sir John Bell and working on a ‘sector deal’. A set of spending commitments and policies should follow shortly. The UK’s life sciences companies will be watching intently, to determine what kind of opportunities await them and work out their next steps.
“The UK has terrific assets, and having a really vibrant life sciences strategy makes very good sense,” says Lechler. “The rate of discovery relevant to health is getting faster and faster, so it’s very important we stay on the crest of the wave.”
This article appears in the December 2017 edition of Pharma Technology Focus