Understanding how patients access medicines in England

Nina Pinwill (NHS England and NHS Improvement): Equity of access for all users is a core responsibility for health care providers and there are other options for access beyond online access.

Paul Catchpole (Association of the British Pharmaceutical Industry (ABPI)): Without a formal study it is difficult to know the answer to this, however, intuitively it feels like this may be the case. It will therefore be important to do more work in this area, as it is clear that continued access to online facilities needs to be strengthened even further in the post-Covid-19 world now that we have demonstrated the utility of this for many patients.

Sally Warren (The King’s Fund): Even before the Covid-19 pandemic, the digital divide has been viewed as a potential risk factor for widening inequalities, particularly when thinking about access to digitised health care. As the pandemic is still under way, it is too early for robust evidence on the impact it has had on medications assessments and optimisation. However, there is some emerging work on the general impact of Covid-19 on digital exclusion.

Paul Catchpole (ABPI): It is still early days on outcomes-based payment; and work is needed to turn these from theory into practice. We need to work together to make such schemes a reality. They are not a panacea nor an answer for every situation but for some types of medicines they will be really important

Nina Pinwill (NHS England and NHS Improvement): The NHS England and NHS Improvement response to Covid-19 has meant the publication of the commercial framework [on access to medicines] is happening later than planned. There are established processes for the management of medicines shortages operated by the Department of Health and Social Care and NHS England and NHS Improvement.

Paul Catchpole (ABPI): This is a very live area of activity at the moment as we seek to understand the alignment there will be across medicines regulation, manufacturing and supply post-January 2021

Sally Warren (The King’s Fund): The barriers to access to medicines and care faced by people from ethnic minority backgrounds are multi-faceted, complex and vary from community to community. Cultural awareness, cultural attitudes, levels of health literacy and inequalities in experience of health care all contribute towards these barriers, alongside wider societal inequalities which disadvantage people from ethnic minority backgrounds. In 2018, Public Health England issued guidance to local authorities to support local and national action on race inequalities in health and these give a flavour of some of the action that can be taken to start to address these disparities.

Paul Catchpole (ABPI): The Covid-19 pandemic has brought into sharp focus the opportunities for using technology more effectively and we need to capitalise on the progress made going forwards. There are many great solutions that have been piloted or rapidly rolled out over the past four months.

Sally Warren (The King’s Fund): In our 2018 report which explored the impact of digital technologies on the future of health care, one of the areas of benefit that was highlighted was the potential for genomics and precision medicine in the next five to ten years.

Nina Pinwill (NHS England and NHS Improvement): ATMPs are following the same process as any new medicine; regulation, assessment by the National Institute for Health and Care Excellence (NICE) and if recommended, they are funded by NHS England and NHS Improvement.

Paul Catchpole (ABPI): Companies must set net medicine prices at a level that is sufficient to meet the NICE cost-effectiveness threshold and demonstrate value for money, if they wish their medicine to be made available on the NHS.

Paul Catchpole (ABPI): The industry is working hard to lower its carbon footprint across all areas, including manufacturing. Progress is being made and it is an industry priority.