How data can lead to better health equity
John McNeill, Executive Director, Value, Access & Devolved Nations
| MSD
With the Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) agreed between government and industry, MSD believes that focus must now turn to implementation to improve health outcomes. John McNeill, Executive Director at MSD in the UK, writes about the opportunity to achieve this
We were pleased to see a number of important commitments within the VPAG related to medicines access, adoption and outcomes, but for these to have the desired impact on health, the ambition to implement them must be high.
NHS England (NHSE) has committed to improve data transparency at national and local level, to track variation in adoption of NICE recommended medicines, and increase visibility of local variation in implementation of NICE guidance. With these commitments comes the opportunity to improve health equity, by leveraging the data available to lead to equitable adoption of clinically and cost-effective medicines.
NHSE’s commitment to track variation in adoption of NICE recommended medicines between Integrated Care Boards includes the continued development of adoption measurement tools, such as the Innovation Scorecard and Estimate Reports, which will be updated and published bi-annually. The Innovation Scorecard reports on the use of medicines in the NHS in England which have been positively appraised by NICE, and the Estimate Reports compare the expected adoption of NICE recommended medicines to the actual volume of medicines used, but covers only a sub-set of medicines.
The Innovation Scorecard aims to support and drive NHS compliance with NICE Technology Appraisals and was designed to help the NHS identify variation which can then be justified, challenged or acted upon. The Scorecard includes a significant amount of data and has the potential to deliver on the objectives of the VPAG commitments.
For this to happen, it is vital that we have the right infrastructure and metrics in place to enable these tools to deliver and crucially monitor how the VPAG is performing. The commitment to continued funding and development of the report should aim to allow publication with additional estimates or groupings and continued improvements in analysis of the data that would allow users to identify where variation exists.
NHSE’s commitment to increase visibility of local variation in the implementation of NICE guidance will enable them to identify where variation in local formularies may be creating barriers to access. During the Covid-19 pandemic, the health service harnessed the power of data. We learnt that certain groups weren’t accessing treatments, which encouraged us to understand why and address that with relevant programmes. Identifying the reasons for variation is vital, but visibility of where it exists is a prerequisite in the equation.
Additionally, accountability is a key issue which needs to be addressed. There must be clarity around what the process should be in managing the outputs from the Innovation Scorecard and Formulary Minimum Dataset, and importantly who is responsible for addressing any issues identified and by what means. Transparency around the outputs and actions which usually remain behind closed doors will be an important step in ensuring accountability for those responsible for implementation.
The VPAG establishes commitments for the next five years, but the benefits will be realised over an even longer period. How these commitments are delivered will reflect on the overall operation of the Scheme. There is a real opportunity at stake – better, more equitable provision of healthcare, informed by data. We are committed to supporting the NHS in the implementation of these commitments; it is incumbent upon us all to deliver on our ambitions for health in the UK.
MSD is a leading life sciences investor and partner to the NHS. For more information, please visit www.msd-uk.com
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MSD has provided funding for this segment.
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