One of the major aims of the proposed new schemes for value-based pricing of medicines is that of ‘promoting innovation’. The idea is that if we ascribe a higher value to more innovative drugs, we will encourage the development of such drugs by the pharmaceutical industry. Drugs which present a greater increase in value over existing medicines, through providing a much greater health benefit or wider societal benefits will be given a greater value.
However it is important to remember that there are also other ways of promoting innovation than through pharmaceutical companies.
1. Academic Research
Instead of paying a premium for increased research and development by drug companies, we could fund more research directly, through research councils. Research undertaken by academic bodies is aimed at understanding the fundamental principles of science as well as at developing better medicines. A greater understanding of fundamental biochemistry and the development of new techniques is more likely to lead to a step change in medicine development.
A growing proportion of recent medicine developments have come not from large pharmaceutical companies but from spin-outs from research institutions. To foster innovation we need to continue to support such ventures through grants and start-up funding.
Academic research is published so that it can be built upon and used by others. In this way any new finding can inform the work being done by others. Because of this, work done within academic research laboratories can be built upon not only by others in academia but by those within the pharmaceutical industry. Building up a strong academic research sector is one way to encourage pharma investment with scope for collaboration and sharing of ideas, as well as generating a strong highly-skilled workforce.
2. Innovation within the health service
Increased freedom and the development of a more commercial mindset within the NHS will help to allow greater innovation within the NHS itself. The development of more efficient pathways within the NHS, along with preventative medicine and early intervention is often a better investment than pharmaceuticals. This has been repeatedly pointed out in relation to cancer by Sir Mike Richards, National Clinical Director for Cancer and End of Life Care.
Often within the NHS the problem is not lack of innovation but lack of spread of innovation. We need to build a culture of copying good ideas rather than reinvention of pathways by individual trusts. Thorough evaluation of new practice and dissemination of results is key to persuading other trusts of the benefits of new ways of doing things.