25 November 2022
The life sciences sector can play a meaningful role in reducing health inequalities through targeting two major challenges facing health systems: the increasing number of people living with multiple health conditions which means more than one illness, and the way health systems are currently structured to reward activity over health, according to LCP.
Their report ‘How life sciences can address the greatest global challenges and level up health’ outlines what practical steps the sector and health systems can take to open up a healthier and more prosperous future for all.
While the risk of dying from common conditions such as heart disease and strokes has reduced substantially in recent decades, more people are living in poorer health for longer. Multimorbidity is increasingly common with more than 50% of adults living with two or more chronic conditions in England. LCP argues that there needs to be a radical shift in the way health is approached, moving away from treatment of single diseases and towards patient-centred care that reflects the increasingly complex health needs that make up populations today.
The second challenge is the current structure of payment approaches for medicines. The way that healthcare and medicines are currently evaluated is usually linked to the number of treatments that hospitals and doctors carry out. If the system was changed and there was reward for keeping people healthy, this would translate into less hospital visits and admissions and would help to drive more innovative approaches to health . The report outlines feasible changes to transform health systems from importers of illness to exporters of health. While the Covid-19 pandemic and the rapid advent of vaccines made clear the societal value that medicines can bring, this is rarely captured, quantified or incentivised.
Health improvements will not only reduce pressure on the healthcare system, but will lead to widespread economic benefits. Healthy employees will boost productivity and as a result there will be less pressure on the economy to support health, income and living. With those living in the most deprived areas falling into poor health 20 years earlier than those in the least deprived areas, addressing poor health would also address widespread inequalities. The life sciences sector has a key role to play in this ‘levelling-up.’
The report outlines several practical ways this vision can start to become reality:
Life science companies can meaningfully reduce inequalities and drive prosperity in communities however clarity is needed to target these efforts:
- life science companies should know and publish the inequalities in the disease relevant to their medicine or technology. This should become a requirement of Health Technology Assessments, which are assessments undertaken by health bodies to evaluate the success of a treatment.
- Life science companies, along with research and development partners, should invest in identifying the common diseases that are found in people who have several conditions while HTA bodies (NICE) and healthcare providers should develop patient-centred, rather than disease centred, clinical prevention and treatment guidelines
- Post marketing surveillance of medicines should include active monitoring and reporting of inequities in access.
Real World Evidence (RWE) has a crucial role to play in providing key insights into patient need but this evidence must be representative. This kind of data is typically more representative of patients because it isn’t as selective as the normally younger, fitter and less medically complex who are selected for clinical trials. LCP believes this data can be harnessed much better to identify new drugs and monitor long-term impacts.
- Clinical trials should be representative of the patient population relevant to the disease area and include people living with multiple chronic conditions
- Data registry sponsors and research funders and study sponsors should make sure that they include data relevant to health inequalities when setting up new studies and data collections.
To better control the current 20 year gap in health life expectancy in the UK, prevention should be prioritised when it comes to the medicine development pipeline
- Life science companies should focus research on drugs that target biomarkers, which are molecules that can give early indications of disease. There is emerging research about the links between multiple age-related diseases and this could really help to target the issue of more people living longer but unhealthier lives.
- Medicine manufacturers should minimise the risk of adverse drug reactions through systematic assessment of the risk of drug-drug interactions at compound development.
Bodies such as NICE evaluate value based on an ‘average’ individual and ‘average’ costs to the healthcare system. As Covid showed, the vaccine had many societal benefits including helping to prevent lockdowns and getting the economy back on track. A more holistic approach is needed to this evaluation and bodies such as NICE and the industry need to work collaboratively to identify additional measurements of evidence and for new and comprehensive guidelines to be developed.
- NICE should run focussed consultations that involve a range of stakeholders including patient bodies to identify additional areas of value. From this, comprehensive guidance on how and when additional elements and areas should be included need to be developed by NICE along with recommendations for further methodological research.
- A broader approach to evidence generation would particularly help in the development of medicines for rare diseases. The current evidence requirements to support payment is undeliverable for many patient cohorts. The industry could leverage real world data to set innovative reimbursement mechanisms to fill this data gap, such as Patient Reported Outcome Measures (PROMs) which are self-completed surveys.
- Health inequalities should become a core part of commercial agreements.
Dr Jonathan Pearson-Stuttard, Head of Health Analytics at LCP and author of the report, commented: “Health is one of our most untapped opportunities for prosperity and happiness, as individuals and as a society. The swift development and blanket roll-out of the Covid vaccine thanks to government, scientists and producers working together highlighted what can be achieved and the value of medicines to our daily lives.
“The life sciences sector has a role to play in helping to paint a broader picture about the value of medicine in society through harnessing the power of real world evidence and focusing research on the areas that will help the most deprived. But there is also the need for governments and health systems to shift the emphasis from illness to health and to start to treat people holistically rather than on an illness by illness basis. We see stories about the immense strain on the NHS daily and we know that Covid has exacerbated the already existing inequalities across the country. This pressure will have repercussions on the economy and wider society and we need to allow the life sciences sector to help level up our health and provide a brighter future for more people.”
The Chief Executive of The Association of British HealthTech Industries, Peter Ellingworth added: “Health inequalities have been laid bare in recent years, with covid really exposing the disparity between populations, both within the UK, and across the globe. Tackling this is one of the greatest healthcare challenges of our time and a data-led approach will be key to enabling the life sciences industry to play its part in improving outcomes for all citizens. We look forward to working with LCP, and wider stakeholders, to ensure HealthTech plays a critical role in this mission.”