Clinical commissioning groups (CCGs): how will they change pharma’s funding pathways?
The NHS and its changing landscape is the subject of much debate and quite rightly given its enormous influence over the industries we all work in. With that in mind, how will the devolution of Primary Care Trusts (PCTs) and the shift in NHS buying power to the newly introduced clinical commissioning groups (CCGs) in April 2013 affect funding?
What are clinical commissioning groups?
CCGs are groups of GPs tasked with designing local health services in England; they’ll commission and buy health and care services including elective hospital care, rehabilitation care, urgent and emergency care, most community health services and mental health and learning disability services. Find out more
So how does a pharmaceutical company gain funding for a drug at the moment?
The NHS website explains the process: “A pharmaceutical company will make an application to one of two drug regulatory bodies: either the European Agency for the Evaluation of Medicinal Products (EMA) or the UK’s Medicines and Healthcare products Regulatory Agency (MHRA). The application and all the research evidence is then examined by experts, who judge the drug’s safety, quality and effectiveness. Neither the Department of Health nor the National Institute for Health and Clinical Excellence (NICE) play any part in this process. The application is a confidential matter between the drug company and the regulatory body.”
Once a drug has been given a License it’s then passed to NICE to evaluate; it’s NICE’s job to ensure that the NHS spends its money on the best treatments in the most efficient way. NICE will either recommend a form of treatment or decide not to fund it. Currently, once guidance has been given the local Primary Care Trusts (PCTs) are more open to release funding. Historically, PCTs have been empowered to decide whether to fund new treatments if and when they receive a request from a local patient or doctor.
So how are CCGs different?
- Average CCG size will be considerably bigger than the PCT
- The size variation between the biggest and smallest CCGs will be bigger
- Management resources will be lower for CCGs and as a result more of their functions will be shared between other CCGs or delegated to commissioning support services or organisations
- PCTs are primarily administrative constructs whereas CCGs will be influenced by clinical flow, population, professional relationship patterns in the area and existing administrative boundaries
The King’s Fund, a charity working to improve health and health care in England, reports in more detail here
So how does this affect funding?
GPs within CCGs will be encouraged to work with drug companies on commissioning screening services and care pathway designs; the Government’s proposed ‘joint working agreements’ that encourage a partnership approach. Guides have been drawn up by the Association of the British Pharmaceutical Industry (ABPI) with the support of the Department of Health.
Read the article in full here
In August 2012 Stephen Whitehead, CEO of the ABPI shared his viewpoint on CCGs and the NHS in an article published on GPonline.com. He said:
“With clinicians having front line experience of treating people day in, day out, and appreciating how medicines can improve patients’ lives, CCGs should be better placed to make decisions on medicines spending compared with SHA managers. Practising health professionals also appreciate that when medicines are used in the appropriate way, they can save the system money by changing a patient’s pathway and mitigating the effects of their disease. This reduces their need for expensive secondary care in later months or years by slowing, or sometimes even stopping the progression of their illness.
A final point for consideration is if medicines are not used by the NHS, it means pharmaceutical companies will struggle to research and develop new treatments because they will be unable to generate a sufficient return on their initial investments. This is a serious issue because we need medical science to advance and new cures to be discovered as we continue our battle with disease. The level of investment required to bring a new medicine to market is significant – it takes on average 12 to 15 years to develop a medicine, at a cost of over £1bn. Whilst only one in every 5,000 of these chemical compounds ever actually makes it to market. These are huge risks and costs industry has to overcome and that is why when the NHS buys the medicines of today, they are investing in the medicines of tomorrow.”
Read the article in full here
It remains to be seen what impact CCGs will have on funding in reality but it’s clear that steps are being taken to enhance the relationship between the clinicians, the pharma companies and the patients.
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