NHS must prepare for future advanced therapies, says ABPI report

ABPI report recommends NHS to update its payment models for future advanced therapies

A new report from the Association of the British Pharmaceutical Industry (ABPI) has highlighted that while the NHS has made significant progress in the introduction of cell and gene therapies, the health service must “do more to get ready for the arrival of the advanced therapies of the future.”

The ABPI noted that advanced therapies, also known as Advanced Therapy Medicinal Products (ATMPs), offer hope for diseases previously deemed “untreatable.”

ATMPs have already been introduced for treating some rarer conditions, including haemophilia, spinal muscular atrophy, and a rare disease that causes blindness.

“In some cases, these therapies can transform people’s lives with just a single treatment,” the Association said.

The ABPI’s report, titled Unlocking Access to Future ATMPs in the UK: Comparing International Approaches, emphasises the need for the NHS to revise its payment strategies for upcoming therapies.

“Many existing advanced therapies are in rare disease areas with relatively low numbers of patients, making it easier for the NHS to budget for the treatments.

“However, some therapies now in development are aiming to address conditions with larger patient populations, including certain types of dementia or Parkinson’s disease. As a result, the health system will need to adapt its approach to paying for these medicines,” it said.

The ABPI reported that over the past five years, the UK medicines regulator has approved an average of two ATMPs annually. However, this number is expected to rise significantly, reaching 1 to 10 - 15 approvals per year by 2030.

Additionally, the number of patients who could receive these therapies in the UK is projected to rise from 2,500 in 2021 to as many as 10,000 per year by 2028.

The ABPI report pointed out a challenge for the NHS in using advanced new therapies -the uncertainty about how long the benefits of any treatment might persist.

“Clinical trials are necessarily conducted over a relatively short time, which creates challenges for bodies like NICE to value the long-term benefits of these treatments when the evidence is still uncertain,” the association noted.

Richard Torbett, chief executive of the ABPI, stated that advanced therapies have the potential to save the NHS significant amounts of money.

He said: “Advanced therapies have the potential to transform patients’ lives with just a single treatment, avoiding a lifetime of care. In the process, these treatments can in some cases save the NHS a lot of money over the long term, which is better for the taxpayer and the patient.

Torbett stressed the importance of viewing health spending as an investment:

“We need to take a long-term view of the value and cost-effectiveness of medicines, looking not just at the upfront costs, but at the lasting outcomes we want over years and decades.”

To achieve this, Torbett highlighted the need for innovative payment models that can respond to real patient outcomes.

The ABPI report also recommended some regulatory changes to improve the UK's ability to research and manufacture these cutting-edge medicines more easily, including:

• Allowing NICE to use a lower ‘discount rate’ to determine the future ‘value’ of ATMPs.
• Exploring innovative medicine payment methods that spread costs over time and link payments to treatment outcomes.

Additionally, the report called for enhancing the UK's appeal as a destination for commercial clinical research into advanced therapies.