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Commercial framework: working in partnership with the pharmaceutical industry for the benefit of patients

The NHS in England spends around £18 billion on medicines a year. Against this backdrop, the NHS has to do everything it can to get access to innovative medicines for patients, while making sure we do so at great value and cost-effective prices to the NHS and taxpayers.

I joined the NHS in October 2018 after 24 years in the pharmaceutical industry for one reason – to make a difference for patients. I felt that by joining the NHS I could use my experience and knowledge of the industry, in the UK, Europe and globally, to support the NHS and the pharma industry to work together. My team’s role, the Commercial Medicines Directorate, is closely linked to NICE, to help patients to get the best outcomes and treatment, and to help the NHS and taxpayers achieve maximum value from the NHS’s significant spend on medicines.

Make no mistake, it is the clinicians and dedicated NHS staff that do the hard work patient by patient, ensuring they get the best possible care. My team’s job is to ensure the medicines are available for them to use appropriately.

I am therefore delighted that today we have published our Commercial Framework for consultation. There are no new proposals in this document, but it is designed to be a guide on how best to work fairly with the NHS and reflects what we have learned over the last year which has allowed us to put deals in place for Spinraza for spinal muscular atrophy, Hemlibra for haemophilia, and most recently Orkambi and Symkevi for cystic fibrosis. These are all cutting edge treatments that will improve the lives of thousands of children and adults.

My team does not get involved in all decisions about medicines funding. For example, some new medicines go through the NICE appraisal process without major issues. Where we do get involved, we will never offer any pharmaceutical company a blank cheque, but we can offer flexibility – in particular for those medicines where clinicians tell us that these are a priority.

This includes medicines such as those used to treat Hepatitis C. By working in partnership with clinicians and pharmaceutical companies we believe we can be the first country in the world to eliminate Hepatitis C. This first-of-its-kind agreement, with Gilead Sciences, Merck Sharp and Dohme (MSD) and AbbVie, will see the three drug companies working together – and supplying these curative medicines at a price fair to taxpayers – to proactively identify and treat people who may be unaware they have hepatitis C.

It’s this kind of approach that marks the NHS apart from most other healthcare systems around the world. Our large purchasing power means we can get access to ground-breaking new treatments for patients, while ensuring we can stretch our pound to cover as many patients as possible and get some of the best prices in the world.

Our recent work on adalimumab through the Medicines Value Programme working with Pharma, clinicians and patient groups, has allowed us to save the NHS around £300 million – this is money that will be reinvested back into patient care.

The publication of the draft commercial framework is another milestone in working collaboratively with industry to secure fair and responsible deals for patients and I look forward to hearing your views.

Blake Dark

Blake is the Commercial Medicines Director for NHS England. He is NHS England’s chief negotiator with the pharmaceutical industry and SRO for the broader cross-organisational Medicines Value Program.

Blake‘s team oversee all commercial discussions with companies in relation to individual drugs: Drugs that trigger the £20 million budget impact test (BIT); commercial arrangements associated with the Cancer Drug Fund (CDF); commercial arrangements relating to NICE’s Highly Specialised Technology appraisal programme (HST); commercial arrangements relating to NHS England’s clinical policy process overseen by its Clinical Priorities Advisory Group (CPAG).

Blake also leads a procurement function relating to medicines used in secondary care; Commercial Medicines Unit (CMU).
Before joining NHS England in Oct 2018, Blake held senior roles in the pharmaceutical industry for 24 years at Sanofi. Blake has led both innovative pharma and generic businesses in the UK for 15 years and 9 years running innovative pharma businesses across multiple countries in Europe and as Commercial Operations Head for Sanofi’s global generic’s company.

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