In the diverse healthcare landscape of Great Britain, strategic advice on pricing & reimbursement is crucial for pharma, biotech and medtech companies aiming to access the market. As a leading consulting agency in the UK, our firm is dedicated to offering unparalleled guidance to companies eager to understand the intricacies of market entry in England, Scotland, Wales, and Northern Ireland. There are different pathways for primary and secondary care and medicines vs medical devices for example. With a global team of experts, specialists, and consultants, we support businesses navigating the healthcare system and Pricing & Reimbursement pathways of the United-kingdom. Trust in our consulting agency to provide the expertise and insights needed to thrive in the dynamic UK market.
UK Healthcare Market Access: Strategic Insights into Pricing, Reimbursement, and HTA Processes
Obtaining health technology appraisal endorsement and ensuring pricing and reimbursement in the United-Kingdom
The United Kingdom (UK) holds a pivotal position within the European markets, notably due to the size of its economy and the influence of its health technology appraisal agencies. Both the retail and hospital markets in the UK are of paramount importance, and future shifts in this market can wield a substantial impact.
However, considering the decentralized nature of the UK healthcare system is vital, which can result in variable timelines for achieving reimbursement and formulary listing through different agencies.
Funding of medicines is contingent on demonstrating cost-effectiveness. When determining the cost-effectiveness of medicines, the United Kingdom relies on a cost-utility assessment based on quality-adjusted life years (QALY) and the expertise of health technology appraisal (HTA) bodies. For pharma, biotech and medtech companies it is essential to enlist healthcare consulting firms with relevant experience in the UK.
There are several HTA bodies, most well-known is the National Institute for Health and Care Excellence (NICE) responsible for England, for Scotland the SMC (Scottish Medicines Consortium) issues guidance whereas for Wales in certain circumstances the AWMSG (All Wales Medicines Strategy Group) conducts HTA unless NICE guidance is adopted. NICE now applies different cost-effectiveness thresholds based on the setting, including a severity of disease modifier. It considers two different – but related – measures of disease severity: absolute QALY shortfall (AS) and proportional QALY shortfall (PS).
It is worth noting that decisions in the UK may differ from those made in other European countries, as exemplified by a number of medicines reimbursed e.g. in France and Germany but not in the UK. However, the UK does provide funding opportunities for effective yet expensive cancer drugs through the Cancer Drugs Fund (CDF).
Aligning Hospital and Retail Markets: Growth Opportunities and Reforms in the UK Healthcare System
In the hospital market, while Integrated care systems (ICSs) establish local formularies for retail drugs, National Health Service (NHS) trusts handle secondary care. The hospital setting aligns with the requirements and standards of the retail market, presenting a growth opportunity in the UK healthcare landscape. Recent reforms have aimed to establish a higher cost-effectiveness threshold for very rare conditions and develop fast-track pathways, often in consultation with market access specialists.
To optimize access to the British market, targeted market access activities should commence well before Medicines and Healthcare products Regulatory Agency (MHRA) approval. However, it is crucial to note that market access preparations should continue even after MHRA approval, particularly considering subsequent HTA and pricing and reimbursement processes e.g. with NICE.
Medical devices and consulting expertise
For medical devices in the UK, it is critical to assess the Pricing & Reimbursement pathways. Medical devices can be subject to HTA appraisals by HTA bodies such as NICE. MedTech Funding Mandate (MTFM) policy that launched on 1 April 2021 aims to ensure patients and the NHS benefit from clinically effective and cost-saving medical technologies faster and more equitably. In order to succeed in this environment, most companies seek the guidance of a skilled consulting agency.
As an expert consulting agency, Justin Stindt Consultant offers strategic advice on pricing & reimbursement pathways in the UK.
At Justin Stindt Consultants, we possess in-depth knowledge and expertise in navigating the complex landscape of market access in the United Kingdom. Our team of experts can guide you through the intricacies of the UK healthcare system, facilitate engagement with regulatory and HTA bodies, and develop tailored market access strategies that ensure optimal patient access and commercial success. Contact our consulting agency today to learn how we can support your journey into the UK market and maximize your opportunities for success in Pricing & Reimbursement.
We offer a strategic assessment of the Pricing & Reimbursement pathways for your asset in the UK. This will include an overview of the available pathways and specific recommendations which pathway would be optimal for your asset.
If you want to determine the price potential of your product, we develop Pricing & Reimbursement strategies.
If you have any questions on Pricing & Reimbursement pathways – UK and for support in identifying the optimal pathways for your asset, please contact one of our consultants in England, Scotland or Wales.
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