Implications of Accelerated Access Review


Image credit: Healthcare Times

In 2014, the then Minister for Life Sciences, George Freeman, launched the Accelerated Access Review (AAR) with the vision of “getting the best technologies to patients more quickly and more cheaply, in a system that is quick to adopt innovation”. The group tasked with the AAR had the goal to make recommendations on how to accelerate access for NHS patients to innovative medicines, medical technologies, diagnostics and digital products and to make the UK the best place in the world to design, develop and deploy these innovations.

At that time, the UK was firmly in the European Union with a strong life sciences industry, and the NHS was perceived as a potentially crucial asset in further developing it. Since the UK voted to leave the European Union, the importance of these aspects have been amplified. Nowadays, it seems clear that the life sciences industry will provide a crucial pillar for future economic growth.

The Accelerated Access Review (AAR), with its final publication on the 24th of October, thus creates a first essential step in ensuring that the UK builds a capability in life sciences that leads to strong economic growth. It also needs to provide patients, and the NHS, with much needed tools and technologies at an affordable cost.

The financial pressures on the NHS means that it is more important than ever to ensure patients can access the most cost-effective new innovations in a way that is affordable and sustainable.

Proposed changes

The review says that accessing innovation in the NHS has become increasingly challenging and frustrating for clinicians and patients. They often have to wait for life-saving treatments, and innovators must navigate multiple processes before their products can be used.

Through the new partnership, innovators would be able to access combined help for clinical development, regulation, and assessment of cost-effectiveness. Patient access to drugs may be accelerated by up to 4 years if a scientific opinion from the early access to medicines scheme is used (saving 12 to 18 months) and there is no delay during the technology appraisal (which can take up to 2 years) or during the process for NHS commissioning and adoption (which can take 2 years or more).

The review recommends a simpler process for digital technologies, often developed by smaller companies such as healthcare apps for managing long-term conditions.

Also important, the review suggests that a new strategic commercial unit should be created within NHS England to enter into commercial dialogue. This would create flexible arrangements with innovators, who are working on transformative new products. The unit would aim for “win-win” scenarios, where innovators benefit through earlier access to the NHS market and increased sales. In return, innovators would offer better value to the NHS and patients.

In summary, an accelerated access pathway for strategically important, transformative products, should align and coordinate regulatory, reimbursement, evaluation and diffusion processes to bring these transformative products to patients more quickly.

Future implications for medical companies

Especially after the decision to leave the European Union, the UK aims to be recognized as one of the best places for medical innovation in the world; meaning they will need to attract investment and development to improve quality of life.

Among all proposed changes, the establishment of a commercial unit within NHS England, with the capacity and capability to consider a range of flexible pricing models as part of a commercial dialogue with innovators, can definitely shift the discussion from short-term costs to long-term value and benefits. Building the evidence base for a strategically important product is of value to innovators, which will probably lead into risk-sharing agreements to share the benefits of accelerated access and recognize any uncertainty in the evidence base.

We at ValueConnected look forward to the next steps of implementation of the AAR and how this may change the healthcare industry prioritization in the UK, and even in the European Union.

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