Where next for the Accelerated Access Review?
02 November 2016
At the heart of the Accelerated Access Review, an independent review on behalf of the UK Department of Health and supported by the Wellcome Trust, is a simple vision: “Getting the best technologies to patients more quickly and more cheaply, in a system that is quick to adopt innovation.” But the apparent simplicity of that goal is in contrast with the complex and challenging reality of creating the processes and systems that will allow patients to benefit from innovation. In addition, encouraging companies to develop new treatments and medical technologies in the UK demands the right commercial constructs and funding mechanisms that will enable innovation to flourish.
The Accelerated Access Review’s final report was published on October 24th. It contains a framework of recommendations for the optimal path forward, taking in the views and inputs of multiple stakeholders, right across the healthcare ecosystem. Strategy& was invited to be part of the AAR programme, focusing on two key workstreams that developed recommendations for consideration of:
- Accelerated pathways to approval;
- A flexible pricing framework to support reimbursement of products under early access schemes.
In addition, Strategy&’s independent review of the Early Access to Medicines Schemes (EAMS) also contributed to the thinking for the future of the AAR.
Overall, we’re pleased to see that the independent review’s recommendations were largely taken up and the thinking behind them developed. It’s also encouraging that the review has recommended between five and 10 medical technology products per year could be designated as ‘transformative’. This will give multiple innovators access to this platform annually. We also welcome the focus on horizon scanning, including partnership with patients and the public.
In particular, there are three key areas that we see as essential to delivering an environment in which innovation can flourish.
The first is the possibility of smaller companies and not-for-profit organisations receiving EAMS funding in order to support early market access. This builds on some of the success that the scheme has already achieved.
Second is the accelerated NICE review, to take place in time with the regulatory approval, and the creation of a strategic commercial unit operating independently of NICE, to negotiate commercial arrangements on behalf of the NHS. Although separate from NICE, the negotiations will inform NICE’s recommendations, thereby avoiding the need for post-hoc, last-minute arrangements for patient access schemes which can cause delays.
Finally, creating structures and mechanisms for real-world data collection is essential. Evidence of the impact of particular new technologies and solutions needs to be made widely available, with the appropriately robust safeguards, in order to support and enable further innovation.
The Accelerated Access Review provides a framework that could help the UK become a beacon of healthcare innovation. With the full backing of the NHS already in place, moving forward requires all stakeholders in the healthcare system to come together to fund and support new initiatives. The development of a digital health infrastructure to encourage take-up of new products and the acceleration of new thinking will all be key to foster innovation and make the UK an attractive venue for investment and development. To that end, we agree with the Accelerated Access Review's approach to leveraging existing bodies - embedding innovation within the existing healthcare infrastructure, making use of the Academic Health Science Networks (AHSN) with a new mandate, and the strong network of Academic Health Science Centres (AHSC), Biomedical Research Centres (BMR) and Test Beds that are already operational within the UK.
As we move towards a new situation for the UK post-Brexit, being able to play the role of an innovation hub will become increasingly critical. The AAR’s final report outlines the route map forward – everyone in the healthcare system needs to start on the journey.