Around the world, health services and the life sciences industry are thinking about converging for mutual benefit. But how can they make this work?
The life sciences industry – pharma, biotech, health tech – run some mostly unchanged business models. They do their own R&D which, as we know, takes many years. And the bigger they are the bigger the sales and marketing workforce seems to be. This is a big expense, it lacks connection to the real world of health services, and it does not help the process of getting innovation into the NHS, even when the innovation is ethically and technically approved.
But the progressives have been repositioning themselves for a while. If you are a Phillips or a Roche, for instance, you have already spent time identifying strategic partners and working on forms of contract with them. For the health tech side of the industry working alongside NHS clinicians will improve the likelihood of a new product forming part of a solution ie a change to the clinical pathway. For a pharma company there is an opportunity to determine the value (or not) of a new drug to the health system but also to the wider interests of patients and populations. Behind this is a strategy to transform the business model with a classic “make or buy” decision – if you can buy into an NHS partnership you can decrease your in-house research and development effort. You may also increase your chances of getting the product to market if it is co-developed with an NHS partner.
This raises interesting questions about how a company finds the right partners – what hard and soft assessments do they need to carry out? Without some due diligence it is easy to burn cash before eventually finding that after the enthusiasm the ability of the NHS organization to partner systematically is limited. We will find companies increasingly scanning the NHS in search of willing and capable partners. Where the emphasis is more on the R than the D of R&D there will also be focus on the local university strength, where pharma in particular has a longer history of collaboration and investment. NHS providers, together with wider STP groupings, would do well to think about the opportunity here. And we are already seeing this in the commercial strategies emerging from some thoughtful trusts.
And why would the NHS be interested? An industry partnership has the potential to set up time and space for innovation activity. What an opportunity for clinicians to have funded time for innovation rather than being largely assigned to getting patients through the ED or looking to place patients with mental health crises in scarce inpatient facilities. This would help many trusts in the direction of innovation development and deployment as required by the Accelerated Access Collaborative. More broadly, trusts have patients, clinicians and data. These have to be on the table with industry in the right way – ethically, legally and financially. The good thing about a false start eg with Deep Mind with patient data it helps the next stage of proposals to be clearer about what needs to be properly addressed. On the financial side it is important that the NHS does not give away its intellectual property opportunities too cheaply. There will need to be national rules on this. Some are already emerging eg on the value of data from Health Data Research UK. The important thing is that some of the progressives are beginning to talk about IP sharing. So the door for the NHS is beginning to open.
Progress in convergence will help the NHS deliver two sets of value: the first, for the NHS, its patients and clinicians as companies invest and give them time to realise their capability to the full; the second, for the growth of the UK economy as key parts of the NHS develop as partners to life sciences. This will depend on the frameworks and agreements which offer genuine mutual benefit.