The UK healthcare landscape is set for a significant transformation as the government announces a groundbreaking five-year medicines pricing agreement with the pharmaceutical industry. This new framework, dubbed the Voluntary Scheme for Branded Medicines Pricing and Access, will replace the long-standing Pharmaceutical Price Regulation Scheme (PPRS) that has governed drug pricing for nearly six decades.
Key Features of the New Pricing Framework
At the heart of the agreement lies a 2% annual cap on branded medicines sales growth to the National Health Service (NHS). Any expenditure exceeding this threshold will require pharmaceutical companies to provide rebates based on their net sales. This mechanism is projected to generate substantial savings, with estimates suggesting approximately £930 million in reduced NHS drug spending for 2019 alone.
The scheme introduces several innovative elements to expedite patient access to new treatments. Most notably, pharmaceutical companies can expect accelerated NICE (National Institute for Health and Care Excellence) appraisals, potentially reducing evaluation timelines by up to six months. This addresses a longstanding industry concern about the UK's comparatively slower adoption of new medications relative to other European nations.
Industry Impact and Market Access Provisions
The agreement includes significant provisions for pharmaceutical innovation and market access. New active substances and immediate line extensions will enjoy freedom of pricing for 36 months from their licensing date, with exclusion from company sales calculations for rebate purposes during this period. Additionally, smaller pharmaceutical companies will benefit from enhanced exemption terms, though specific details are yet to be finalized.
Historical context underscores the significance of these changes. According to ABPI figures, NHS medicine spending under the previous five-year PPRS grew by just 1.1% - representing a 0.4% decline when adjusted for inflation - while overall NHS spending increased by 3.3% during the same period.
Strategic Healthcare Implications
Health Secretary Matt Hancock emphasized the agreement's broader implications, stating it will benefit "patients, the NHS, and the UK life sciences industry." The deal aims to reinforce the UK's position as an attractive hub for research and investment, potentially accelerating patient access to breakthrough treatments.
Mike Thompson, ABPI chief executive, reinforced this view, highlighting the scheme's potential to improve access to effective new medicines and vaccines across the UK. The agreement also includes provisions for enhancing medicine uptake across five key disease areas, though these are yet to be specified.
Commercial Framework and Compliance
Companies opting out of the voluntary scheme will face statutory pricing controls with mandatory price reductions. The statutory scheme, while still being finalized, will impose higher payment rates and exclude benefits such as pricing freedom for new active substances and small company exemptions.
ABPI's executive director for commercial policy, Richard Torbett, acknowledged that while the industry had hoped for more favorable terms, the agreement strikes an appropriate balance given the NHS's financial constraints. Final details of the agreement are expected to be published in December, with implementation scheduled for January 1, 2019.
