This is the second post of the Conditional Reimbursement Series focusing on key European Markets.

For the past years, the National Health Services (NHS) in the United Kingdom has intended to change systems and processes to adopt medical innovation sooner and to encourage the uptake of evidence-based, high-impact innovations. At the same time however, the NHS also understands that the adoption of such medical innovations will need to be carefully managed to protect UK patients while improving their care.

In November 2014 the UK Minister for Life Sciences announced the Accelerated Access Review (AAR), which became the last of several initiatives that looks at the complex issue of how to balance access to innovative medical technologies with the consequential impact on budget and affordability. According to the NHS“The Accelerated Access Review (AAR) aims to speed up access to innovative drugs, devices and diagnostics for NHS patients.”

While Germany and France are leading the way with early access and a strong adoption of medical technologies in Europe, the UK has the potential to become a major influence in accelerating access to innovative technologies worldwide.

Origins of the Accelerated Access Review

The NHS has identified several challenges that are currently hindering access to valuable, innovative technologies and are increasing the cost of medical care in the UK. Some of these challenges include:

  • Lack of perceived value in medical innovations, in that companies focus on product features rather than benefits to the NHS.
  • No clear route to enter and access the UK market.
  • Questions about the implications of adopting a certain medical technology.
  • Difficulties to generate good-quality evidence beyond the standard Randomized Controlled Trials (RCTs).
  • Unclear benefits of the NICE processes due to the gaps between NICE approvals and market uptake of products.

These types of questions are driving the analysis of the NHS, together with several stakeholders in the market, in designing a methodology to ensure the right technologies will reach the right patients at the right time.

Conclusions of the Interim Report

In October 2015 the AAR published an interim report highlighting five propositions that might cause for substantial progress in regards to the NHS goals.

  1. ‘Putting the patient centre stage’: Patients should receive greater say during the various stages of the innovation pathway.
  2. ‘Getting ahead of the curve’: A fundamentally new approach is required for products that promise the most significant benefit, potentially game-changing impact and overall value.
  3. ‘Supporting all innovators’: The innovation pathway should encompass innovations at all levels of the system, and not only products.
  4. ‘Galvanising the NHS’: The NHS must be encouraged to adopt new products and systems quickly and effectively.
  5. ‘Delivering change’: A new system architecture is required at local and national level to accelerate access to the best new products.

After its publication, several stakeholders started or increased collaboration with the NHS, making recommendations for the final report, which is due in April 2016. The complete report can be found here.

Conditional Reimbursement – What is Next?

On the 22nd March, 2016, the NHS published an independent report, consolidating the feedback of more than 150 stakeholders, in how the NHS could improve the environment for innovation, based on the AAR interim report.

Several proposals were considered and conditional reimbursement was among the top 3 that received the greatest number of votes for ‘most attractive’ for stakeholders.

Conditional reimbursement schemes would give companies and stakeholders the opportunity to collect clinical, economic and social data to drive technology adoption, while providing patients with earlier access to innovative products. For this, data infrastructure will be a key success factor.

Existing NHS capabilities may not match the requirements for a conditional reimbursement scheme, so medical companies and the NHS will have the opportunity to establish partnerships to pilot and validate the data infrastructure.

The NHS is seriously committed to improve access to medical technologies, and the participation of stakeholders in the process has indicated a positive impression of the results so far. Medical companies that 1) understand the priorities of the NHS and how medical products can respond to them, 2) effectively communicate these messages as value and 3) partner with the NHS to collect and analyze data, will have a significant head start in introducing their technologies in the UK.

The message is clear: medical companies will need to demonstrate clear and significant value for their products to the NHS.

April is right around the corner, so stay tuned for the final AAR report.

The next post will be the third and last of the Conditional Reimbursement Series, where we will review the Provisional Reimbursement program from the HAS in France.

Do you want to know more about the current progress of the Accelerated Access Review and how it will affect your business models and strategy across European markets? Contact us at and we will be happy to review your questions and help you getting prepared.