SMC Evaluation ProjectThe View From Industry

Martin CoombesGovernment Affairs Manager, AstraZeneca

ABPI Representative SMC Evaluation Reference Group

“The Pharmaceutical Industry is recognised as a key partner by SMC and have supported the development of a robust and transparent decision-making process.”

Life Science MessageScottish Medicines Consortium Work

SMC Evaluation Project

Management Group: Paul Catchpole

Reference Group: Martin Coombes, Jim Swift Andrew McGuigan

ABPI Scotland: Andy Powrie-Smith

SMC User Group Forum

SMC Evaluation Project

• Stakeholder engagement

• Medicines utilisation– Not recommended– Accepted for use/restricted use– SMC advice on unique treatment

• Evaluation of Budget Impact

Stakeholder Engagement• Evolving process• Industry seen as partner

– Continue to increase communication

• SMC process well recognised, timely, straightforward

• Consistent advice, but varying NHS Board processes and application, which would benefit from greater transparency

• Reduce duplication – NICE/AWMSG• More proactive patient involvement

Medicines Utilisation

Medicines Utilisation

• Not recommended

Medicines Utilisation

• Not recommended– 10 medicines remained not recommended

0.1% of the primary care spend 2005/6– Not added to formulary– No means No

Medicines Utilisation

• Not recommended– Delay of SMC advice– Limited use relative to alternative treatments– No alternative licensed products– Influence of pharmaceutical industry marketing strategy – Variation in advice issued by national bodies– Lack of engagement of relevant clinical experts in early

stages of SMC

Medicines Utilisation

• Accepted

Medicines Utilisation

• Accepted/Restricted Use– Data limitations– ‘Where alternative treatments already

exist, implementation of advice is subject to local NHS Board decision making’

– Acceptable variation?– Yes means Maybe

Unique Treatment

• Etanercept for psoriatic arthritis– HDL (2003) 60– No clean and relevant dataset– No single Scottish centre to collate data– Issues around local organisation structure

Budget Impact• Variable

– Actual vs Budget Impact• From +£3.2m to -£11.9m

– Multiple issues• Derivation unclear, Trial drop-out rates,

‘Restricted Use’, lack of uptake

– Compare actual uptake vs BI• Between NHS Boards• Other countries

Forward Look SMC Budget Impact

Key Conclusions

• Evolving and improving• Engagement

– More Pt group contact & Industry communication– Need greater understanding of local NHS Board processes

To provide consistency, transparency and accessibility

• Medicines Utilisation– Data? Variation in uptake?– When does yes mean yes?– Regular monitoring of uptake (compare with other countries)

• Budget Impact– Robust– Actual vs Budget Impact

R & D