2024 Look Ahead: Spotlight on Market Access
Market Access activity in 2023 was far from quiet, and it appears that 2024 will continue to be equally lively. But that is what keeps it all interesting, is it not?!
While there continues to be challenges at the sharp end of access, namely procurement, there have been some positive steps forward in value-based procurement, as well as system recognition of supplier financial and supply chain pressures.
During 2024 we will be working on turning these positive steps into tangible improvements for suppliers, clinicians and patients alike.
The Department of Health and Social Care (DHSC) expects to ‘soft launch’ its value-based procurement methodology early in the new 2024/25 financial year, and to refine it over the course of 2024 before a full launch in 2025. ABHI will be working with DHSC colleagues on this and will be seeking your input to the process as it is rolled-out.
The Health Technology Partnership, industry’s formal interface with government, has established a Procurement Task and Finish Group, and through this forum, we will be working on key challenges in tendering and procurement. We will of course keep you updated with progress.
We have also provided a submission to the National Audit Office in response to their report on NHS Supply Chain, and continue to press for two-way dialogue on improvements, post their re-organisation.
The NHS England Commercial Strategic Framework, published in November 2023, sets out a blueprint for future improvements to NHS procurement. As you will have heard from me before, there is much in the Framework that we support, but while the details behind some of the proposals are lacking, we remain cautious about unintended, or even detrimental impacts, of some of the proposals to both the attractiveness of the UK as a place to do business, as well as access to innovation for clinicians and patients. During 2024, understanding the detail, and shaping positive outcomes, will be a priority for ABHI.
While sustainability is a complex and multifaceted area, and one ABHI has dedicated resource to support, we recognise this is also a market access issue for you. So alongside the day-to-day practical support, ABHI will continue to raise barriers created by inappropriate delivery of sustainability measures through procurement and policy with both the NHS and government during 2024. The implementation of social value, while improving, remains a concern, and we know that the execution of the 2028 milestone of product level carbon footprinting is something you need clarity on sooner, rather than later. This is top of our agenda for you.
Procurement is not the only barrier to market access. For more complex technologies, commissioning plays a significant role in access. Not only through commissioning policy itself, but also through the inclusion of devices on the high cost excluded device list, and uptake of incremental innovations within categories. There are questions about the process and transparency across specialised commissioning, which is why this is a key priority for the Market Access Group in 2024, and a formal letter has been sent to NHS England outlining our concerns.
Last, but not least, there is the topic of health technology assessments (HTAs), arguably the market access barrier of most resource intensity and complexity for any innovator. In the UK, each of the four nations has its own approach, but they do increasingly work in concert and the National Institute of Health & Care Excellence (NICE) continues to be regarded by many, both here and overseas, as the gold standard in delivering HTAs. 2023 saw NICE ramping up the changes in its approach to HealthTech assessments, not least of which moving to use of the term HealthTech to describe their non-medicines programmes. As NICE drives to make its guidance more useful and usable, it is moving away from producing single technology guidance, and where possible and appropriate, delivering multiple technology guidance. NICE is at pains to stress that this is not a class-based approach, where all technologies will receive the same approval for use or otherwise, but will be nuanced based on evidence and cost effectiveness. ABHI recognises that members concerns remain around the direction of travel, particularly the newly commenced late-stage assessments, and we will continue to raise issues and shape improvements as this new guidance methodology is utilised.
I do encourage you to get involved in the vital work we do to support market access whenever you can. Our quarterly Value & Access meetings are a great way to hear from peers and systems leaders on the key topics keeping you all awake at night or getting you up in the morning. If you cannot always make time to attend those, you will still continue to receive information and opportunities to get involved through both Value & Access Group member communications, as well as wider ABHI communications from me.
And, as always, if there is anything that is making market access for you a problem please do get in touch and I will do my best to help out. I wish you all a fantastic 2024!
