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An ambitious plan for faster access to innovative treatments


Professor Paul Workman comments on the recently published findings of the Accelerated Access Review and the importance of speeding up the adoption of innovative drugs and medical technologies.

Posted on 26 October, 2016 by Paul Workman

Graphic that shows front page of the final AAR report

The Accelerated Access Review Final Report: a review of innovative medicines and medical technologies published 24 October 2016

This long-awaited final report for the Accelerated Access Review, published this week, is a welcome step towards earlier access to some of the most innovative treatments for NHS patients. It could help lead to a smarter, more flexible system that provides more rapid and hopefully broader availability of products that transform the lives of cancer patients.

I’m especially pleased that this excellent report recognizes that improving access to truly innovative medicines and other products requires that multiple partners in the ecosystem need to work closely together to find solutions to the major medical problems we face. Importantly, this includes working with innovators to accelerate approvals and providing a clear, simplified and streamlined system for this.

Reducing the time to make new medicines available

The review was commissioned by the UK government with the aim of making it easier for NHS patients to get access to innovative medicines, medical technologies, diagnostics and digital products — and to improve efficiency, care pathways and outcomes for patients.

The review had an external chair — Sir Hugh Taylor — who was supported by an external advisory group. Its preparation involved considerable interaction with key stakeholders including industry, the NHS, patients, academia and clinical experts.

The review makes 18 recommendations and most notably offers the possibility of reducing the time a new medicine is available on the NHS for patients by up to four years. This would be achieved by eliminating delays at the respective stages of NICE appraisal and NHS commissioning and adoption, which can each take two years or more.

Benefits for patients, the NHS, industry and the economy

The report recommends that the most strategically important medicines and technologies should be given ‘transformative designation’. An accelerated regulatory, reimbursement, evaluation and adoption pathway will be offered to these products, which could lead to them being available for patients years earlier than usual. If delivered, this would of course be great news.

I also welcome the greater involvement and collaboration with patients whose voices are so important.  The report recommends that patients be involved in identifying and prioritising treatments suitable for ‘transformative designation’. And there is no doubt that if the recommendations are successfully implemented there will be benefits across the board for patients, the NHS, industry and the economy.

In addition, I strongly support the idea of examining how to make it easier to trial cancer medicines in early stage disease where the benefits may be greater and more easily demonstrated. I would go further and encourage looking at how innovative drug combinations could be trialled and approved more quickly. As I have argued before, treating cancers earlier and with combinations of treatments that work through new mechanisms will be absolutely essential if we are to tackle cancer’s complexity and its ability to adapt and evolve into drug resistant forms — which in turn is critical if we are to substantially extend survival and increase cure rates.

'A step in the right direction'

While welcoming the report as a whole, my main concern is that only a handful of treatments per year – around five to ten across all disease areas — will benefit from the proposed Accelerated Access Pathway. I would like to see changes across the board that provide incentives for a much greater number of innovative cancer drugs to be approved and made available to cancer patients very quickly once their potential becomes apparent. This includes, as the report recommends, changes to the way NICE evaluates treatments, which I have argued in the past need changing to reflect the benefits of innovation.

I have blogged previously about how important it is that regulatory bodies allow early adoption and so I am pleased that this report is a step in the right direction for a system that benefits patients. What is needed now is the rapid implementation of the report’s recommendations and, importantly, the provision of sufficient resources to make this happen.

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