Transparency data

6 June 2019 minutes

Published 3 October 2022

Meeting details

The meeting was held on 6 June 2019 from 10:30am to midday in room G7 at 39 Victoria Street, London.

The chair was Liz Woodeson.

Minutes were taken by Claire Jones.

Attendees

From the Department of Health and Social Care (DHSC):

• Liz Woodeson (chair)
• Rob Kettell
• Daniel Law
• Richard Mattison

From NHS England and Improvement (NHSEI):

• Gareth Arthur
• Helen Scott

Note: NHS England and NHS Improvement have worked together as a single organisation since 1 April 2019. NHS Improvement became part of NHS England in July 2022.

From the Association of the British Pharmaceutical Industry (APBI):

• Louise Houson
• Richard Torbett
• Paul Catchpole
• David Watson
• Ryan Hollingsworth
• Claire Jones

From the devolved administrations (DAs):

• Cathy Harrison (NI)
• Andrew Evans (Wales)
• Greig Chalmers (Scotland)

Minutes of last meeting

The minutes of the last meeting (May 2018) were agreed. One outstanding action from the last meeting was discussed. DHSC had planned to engage with policy think tanks to ensure communications regarding medicines spend support a clear understanding of the ‘medicines bill’ for the NHS in England. ABPI argued that references to NHS Digital reported data needed to be appropriately contextualised. Both sides agreed to take steps to improve wider understanding of spend and growth.

Action

DHSC would follow up with NHS Digital regarding what they publish on medicines spend, and to pursue work with policy think tanks as previously agreed.

The agenda items were reordered to:

4) operations update

5) access, uptake and commercial arrangements

3) scheme metrics

Operations update

DHSC presented data for the 2014 pharmaceutical price regulation scheme (PPRS). Audited data for 2018 under the old scheme rules is expected at the end of September or October.

It was noted the growth in spend covering the 2014 to 2018 PPRS had been quite variable year on year due to market factors, but that the new 2019 Voluntary Scheme for Medicines, Pricing and Access (VPAS) was likely to be more stable because it covers the majority of branded medicines spend and has fewer exclusions.

From 2014 to 2018, there has been a 41% reduction in historic cash payments (HCPs). Half the companies subject to HCPs had opted to buy out and will not be required to make payments under the 2019 voluntary scheme.

DHSC presented the Q1 (quarter 1) 2019 spend data, the first under the new scheme. It was noted that growth of 2.14% (Q1 2019 versus Q1 2018) was lower than the DHSC forecast for 2019, but that a single data point could not predictably indicate the annual trend.

The Q1 VPAS spend, and payment data presented at the time of the meeting is awaiting ministerial clearance and should be published in June.

Action

DHSC would confirm timelines to ABPI.

ABPI stated it would be helpful for industry and other stakeholders to have a clearer view of how Scotland, Wales and Northern Ireland are allocated their share of payments from the scheme. DHSC confirmed that the DAs are paid quarterly in arrears.

ABPI asked DHSC to explain how estimated payments would be taken into account in the planning guidance and allocated to NHSEI, in advance of each financial year. DHSC confirmed that an explanation of the approach would be shared within the end-of-year publication but would clarify this point to ABPI in advance.

Action

DHSC to provide a narrative explaining the approach to apportioning the payments and how these would be taken into account through the mandate to NHS England for the following NHS financial year.

Action

DHSC and ABPI to jointly agree the ‘waterfall’ analysis of spend and growth for the full year 2018 in July.

Access, uptake and commercial arrangements

Horizon scanning

NHSEI updated on work to improve horizon scanning, in line with the ambitions set out in the voluntary scheme. Work is continuing through the commercial framework discussions, and broader engagement with ABPI including through the accelerated access collaborative (AAC). ABPI noted that the horizon scanning scheme metric could benefit from both reflecting the extent to which industry are fulfilling their commercial input, but also reflect how much the information is helping inform system readiness. ABPI requested for clear information for individual companies about what horizon scanning inputs would be required.

Engagement

NHSEI reported that in advance of the commercial framework they had been working on how to ensure more effective engagement. ABPI noted that small companies often required more support in interacting with the system. NHSEI and ABPI had agreed to set up a regular commercial operations group (COG) which would focus on these and a range of operational issues, with the group meeting in June 2019 and every quarter after.

Action

NHS England to confirm who is attending PAMP from their side.

Value assessment

The National Institute for Health and Care Excellence (NICE) has commenced the methods and process review with industry feeding into the methods working group. The outline timetable is for the methods to be updated by early 2021. The timetable will depend on the proposed scale of changes.

DHSC and NHSEI are working closely with NICE to understand the timetable for moving to more products being assessed by NICE. The following areas are being considered:

• HIV and haemophilia products – if and when these should be reviewed
• products that would have gone through the specialised commissioning process
• clinical commissioning group (CCG) commissioned products that may not go to NICE

Action

ABPI and DHSC to follow up with NICE on this timetable as part of their routine conversations.

Commercial framework

NHSEI confirmed engagement with ABPI to date had been positive. There will be further engagement with ABPI before the commercial framework is published. ABPI noted that industry believed progress had been slower than hoped.

NHSEI confirmed that publication is planned for Q3 2019 to 2020, but that the commitments in the voluntary scheme were already being implemented. ABPI said this item would be raised at the patient access to medicines partnership (PAMP) on 4 July 2019.

ABPI noted that there are equivalent documents in place in the devolved administrations (DAs). The DAs confirmed that they were content with plans for engagement.

Transparency across the UK

It was noted that NHSEI would shortly make proposals to the DAs about how the commitment included in section 3.49 (concerned with transparency of agreements with companies between the 4 UK administrations) would operate.

The DAs noted this with thanks and noted that they may make their own proposals on the same issue.

Visibility of tenders

NHSEI highlighted that a contract finder was already in place. ABPI noted that for industry it was important to understand the NHS’s strategic intent around the use of tenders or procurement on branded medicines.

Action

ABPI to raise tendering, capacity concerns and timetabling at next meeting of the Commercial Operations Group between ABPI and NHSEI.

Identification and support of 5 highest health gain categories

Discussions had taken place between NHSEI and ABPI and the technical questions behind the selection of categories had been jointly agreed. The decision on categories would be made by NHSEI and the choice would likely be included in the innovation scorecard in 2020.

ABPI and NHSEI acknowledged the need for the categories to be based on a robust and defensible methodology to ensure the selection adds greatest health gain for patients, and for a clear communication plan to all stakeholders. ABPI raised concerns regarding the timelines.

Action

NHSEI to review the timetable for 5 health gain categories, and will review implementation support necessary to target improved uptake in England.

Scheme metrics

DHSC and ABPI had developed a set of scheme metrics and the outline framework of these was agreed in the meeting. All agreed the importance of agreeing a clear narrative to accompany successive data on scheme success factors. These should be refreshed appropriately, and the narrative on these discussed at subsequent operational reviews between DHSC, NHSE and ABPI.

The impact of the UK’s departure from the European Union on the scheme metrics would be considered in future operational reviews. Future reviews should include trends as reported through the Office for Life Sciences (OLS) competitiveness indicators report, the next iteration of which will be published in June 2019.

ABPI and NHSEI agreed that consideration should be given to how scheme metrics on the commercial activity could incorporate qualitative assessment of the NHS’s view of company engagement in commercial discussions, as well as company feedback.

Action

DHSC will confirm to ABPI when the metrics framework has been approved across government and NHSEI and ABPI will then share the framework with industry.

Action

ABPI will offer views on how often the metrics should be updated and in what form the data should be published.

Action

DHSC will speak to OLS regarding the inclusion of life sciences competitiveness indicators alongside the next operational review.

Any other business (AOB)

ABPI noted that there should be a review of the non-exclusion of sales subject to brand equalisation (BE) deals during the scheme. ABPI had gathered opinions from several companies and reported that at this stage, there was no evidence of changes to supply.

Action

ABPI and DHSC agreed to review the need for a review of brand equalisation once further evidence was available over the next 18 months.