A glance back to Pharma Integrates 2022 – part i

Run by Life Science Integrates, Pharma Integrates was in its eleventh year in 2022. A unique event, leaders from across the pharmaceutical pipeline addressed the needs of the industry, shared their own insights, and tackled debates on the crucial topics that influence the future of patient outcomes.

With pharmaphorum attending the Pharma Integrates 2022 event back in November, held at The Leonardo Royal Hotel Tower Bridge in the City of London, it was heartening to behold that the venue’s first floor was abuzz with leaders in the industry – all there to converse on pioneering change across pharma and healthcare, from concept and data, targets, and trials, to the life-and-blood reality of patients and their families.

Building a life sciences superpower

The day began with a welcome from Trevor Jones, chairman of e-Therapeutic Plc., who called Pharma Integrates the highlight of the pharma calendar year when it comes to conferences. An event centred on sharing knowledge (or the lack thereof, he jested), Jones introduced the day’s first speaker Susan Rienow, country president UK at Pfizer and vice president at ABPI, noting the importance of Rienow’s role at Pfizer from a national R&D perspective.

“Almost three years ago, the WHO was informed of a cluster of cases of pneumonia in Wuhan, China,” said Rienow. “As we now tentatively move on from the immediate impact of the pandemic, as our industry was central to tackling the pandemic, so we are now central to tackling the global challenges we face today.”

Thinking about a few specifics as a sector, Rienow noted an investment of £5 billion in research every year, that life sciences contribute £37 billion annually to the UK GDP.

“You cannot build a science superpower without building a life sciences superpower” she stated. “The medicines and vaccines developed by our industry have a critical role to play. The pipeline of new medicines and vaccines has never looked more exciting.”

Reinvigorating R&D, transforming the UK economy

Nonetheless, Rienow reminded the audience of the signs that the UK is falling behind competitors: the UK share of R&D was 7.7% in 2012, down to 4.2% in 2020, and government figures show just 68% of medicines approved by the EMA were made available and approved in the UK in 2020.

“The first thing to say is that the industry is absolutely committed to turning these trends around,” Rienow continued. “We must, however, work in partnership,” she said. And what would be the prize for such collaboration? £68 billion in additional GDP due to the increase in R&D investment alone and a subsequent decrease in disease burden by up to 40% across the whole of the UK – cardiovascular, mental conditions, cancer, and so on.

With this hopeful projection, Rienow mentioned that the ABPI has set out R&D incentives for investment to reverse the decline in clinical research and make it easier. Alongside partnership, access must be ameliorated to transform the health of patients across the UK, she said. Shockingly, there are 1.2 million patients missing out on medicines across just four classes of treatments.

This is the goal, then: transform the lives of patients; transform the UK economy. “This can only be done in partnership,” Rienow reiterated and concluded.

Transformation of the NHS

Next to the stage were Jenny Ousbey, CEO and founder of Ovid Health, who was joined for a ‘fireside chat’ by Tim Ferris, national director of transformation at NHS England and NHS Improvement. Ousbey requested that the audience “do imagine a real fire” before she enquired after the difficulty of Ferris’ role at present.

“I see the challenge of investing in the future versus the trade-offs for [now] as a chance to clarify and bring to life the specific benefits, as Susan’s [Rienow] excellent opening remarks highlighted very well,” he replied. “We all share the same desire to bring the most effective medications to the people of this country as rapidly as possible. The mechanisms by which you invest in that process are challenging as a delivery system.”

Ferris went on to inform Ousbey that the next day he was to spend time in an ambulance, then go to Number 10 with the secretary of state for health in order to discuss how to sharpen the argument, at a time of shrinking funds and investment.

Ousbey brought up the subject of integrated care systems (ICSs) - 42 ICSs established across England on a statutory basis on 1 July 2022 – and asked Ferris’ opinion on their engagement in a constructive and productive way.

“The use of data – Susan [Rienow] referred to 1.4 million patients who aren’t getting the effective medicines they should be getting – my job,” he said, “is to make that number as small as possible. Two things are happening for this: the change of the organisational structure, the NHS reorganising with an additional layer of governance – I think it has enormous potential.”

“From my perspective,” he continued, “as a public health person and economist, the flowing data has accountability at the top of the ICS and small scale, that can deliver data to the frontline, closing the gaps between eligibility and receipt. This new access to specific data since the pandemic started, with the governance changes – that’s together a great opportunity.”

Partnership and selected focus

“The people who are managing these changes are challenged,” Ferris went on. “There’s a lot of pressure on them: how can we specifically enable that kind of partnership? I have a hunch about the direction of travel: it starts with closing each care opportunity gap one at a time. The industry has a real role to play in supporting the data systems necessary to close those gaps.”

On the topic of partnership, Ousbey asked Ferris whether there was a wishlist of the types of partnerships the sector could come to him with. Deferring that “it’s hard to choose a couple”, Ferris also noted that “by choosing some, you aren’t choosing others.”

“The number one problem is cardiovascular disease in this country,” he explained. “To close the gap, it would save tens of thousands of lives in only a year or two: secondary prevention for those with cardiovascular disease. The [other] one is cancer: the cancer opportunities are really, really big – it’s a little further out, epidemiologically. The biggest delta is between those in treatment and those who need treatment,” he continued. “To caveat: if you have to pick what would be the most juice from the squeeze, those would be it.”

On the subject of cancer, Ousbey noted the challenges with R&D, clinical trials, with data, asking Ferris what can be done in partnership with the NHS: “You said the NHS does not learn enough from the NHS. We probably all share that view, so, what can be done?”

“To take a step back from that question, I like to think about things in context,” Ferris replied. “We do need to ground ourselves in all the positives and make sure we understand that we have enormous positives we can build on. As [Lord] David Prior likes to say, the ‘Meds and Eds’. And in this country, it’s a terrific base to work from.”

Taxis and equitability

“I was in a taxi the other day,” Ferris said, “and the driver’s name was Geoff Simmonds – he told me I could use his name – and he said ‘We could improve the way the NHS is organised in its delivery of services. Before I drove a taxi, I was a supply chain engineer for a procurement operation.’”

Ferris went on to explain that Simmonds’ mother had fallen and broken her hip and described the process of that: “There must have been 15 places in that process I could have, with a more organised system of communications, over a few days, could have [made] a couple of hours,” Ferris quoted, before noting that there are places where there is being done.

“The future is here. It’s just not equally distributed,” he admitted. “It’s a cliched expression, but in the NHS, there are places where the system works really well and other places where it doesn’t.”

Jesting that Ferris’ taxi rides provide more valuable information than hers, Ousbey shifted the conversation to biopharma, to “fantastic things happening up and down the country”, including with regard to tackling health inequalities. Just as cardiovascular disorders, cancer, and diabetes are priorities for NHS England, she asked how biopharma can come to NHS England with ideas.

“Addressing health inequalities is one of the most powerful animating forces across the NHS,” Ferris replied. “Coming from the States, this commitment is one of the most striking things. When you walk in the room, make sure that you are highlighting the opportunities for whatever it is you are selling, highlighting the opportunity to address inequalities. It works really well to build into your clinical trials, or whatever interface, a specific opportunity to address health inequalities. It is harder to do clinical trials in deprived areas, but the benefits to the population and the motivation that it provides to the NHS – it’s worth it.”

Questions, and waiting for answers

To conclude, Ousbey opened the floor to audience questions, one enquiring how the waiting time gap to see a GP in the UK is being addressed.

“We’re so close to using data to answer that question directly,” Ferris said. “But it’s not quite over the line. It’s possible today, but not happening really, except Ben Goldacre’s work at the Bennet Institute – pharmacy reports to GPs specific for that GP. That’s the key. That’s called clinical decision support: if we could make sure those clinicians were using those reports to close the opportunity gaps.”