Future of Pharma Reimbursement, Treatment Access and Funding Approval - why health care rationing will dominate pharma funding - impact on patients and pharma profits

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Notes on keynote for Roche Pharmaceuticals on Drug Treatment Access.

In the past, the major challenge for a pharma company was to develop a new therapy, prove impact in clinical trials, show safety, and get licience approval to enable the product to be sold commercially.  Typically the process could take up to 15 years, and cost up to $1.2 billion, which all had to be recouped in 10 years of sales before the patent ran out.  

But today there is a massive additional hurdle which is persuading cash-strapped governments and insurers to fund a new therapy for patients.  It is no longer enough to prove the therapy works, saves lives, has less side effects and so on.  The pharma company has to make the case that the therapy offers good value for money compared to other treatments for the same condition.  Beyond that even, the therapy may be competing for budget for a wide range of other therapies for other kinds of conditions.

Health rationing is complex and controversial but is taking place every day in almost every government-funded hospital around the world.  Life-and-death decisions are being made by health economists and government administrators, who are in turn being lobbied by patients and their families, activist groups and clinicians.

Here is the future:

1) Pharma companies will need to offer far more sophisticated data about cost benefits – not only things like cure rates, but also measures of improvement of quality of life for those with chronic conditions.  That may also include estimates of lower numbers of working days lost because of ill health, fewer days spent in hospital and so on.

2) Data is not enough: human stories are powerful and necessary.  Decision-makers are ordinary people with families and friends.  They may be swayed by a story of extraordinary success in treatment of a distressing condition, that someone they know has also suffered from.  As Stalin himself once said:  “A million deaths is a statistic.  A single death is a tragedy.”

3) Pharma companies need to work together with government decision-makers to help resolve these complex questions in a collaborative rather than adversarial way.

4) Most important of all, the most compelling approach will always be where the pharma team member sees themselves as a patient advocate, helping sick people fight for the very best treatments available.  And as part of advocacy, working closely with patient groups.  

The moment a pharma team member is positioned as a mere commercial agent trying to maximize drug sales and profits for shareholders, the person rissk losing credibility in the eyes of those who hold responsibility for government budgets.

5) As part of this there are important ethical questions to be asked about what a reasonable price is for a new therapy, given the huge risks of failure in early studies and clinical trials.  Society has a strong interest in a profitable pharma industry, because without it, research funding will rapidly dry up.  The rate of innovation for new therapies is very slow for many different types of illness.  It is shocking to me that a doctor who completed training this year is using a large number of identical medicines to those I was trained to use as a doctor over 30 years ago.

Here is the key: only “sell’ what you really believe in.  

It is not enough to say a drug works.  You need to be certain deep inside yourself that the benefit of the therapy you are promoting, at the agreed price per treatment, is a really good use of public money, compared to the other types of treatments what will need to be cut back, in order to pay for it.  Anything else is just overselling, and lacks integrity.

And always keep in mind how tough the job is of the decision-makers “on the other side” who may well have sleepless nights after agonizing decisions, chosing between different therapies for different groups of people, all of whom would benefit in some way from some extra budget, which cannot easily be found.

Need a world-class pharma keynote speaker for your event? Phone or e-mail Patrick Dixon now.

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