Pharma must work more closely with community pharmacies in the UK if medicines optimisation is to become a reality, according to one of Public Health England’s senior advisers.
Dr Charles Alessi, chairman of the National Association of Primary Care and interim chairman of NHS Clinical Commissioners, said pharma companies must listen to the needs of the pharmacy sector.
Speaking earlier this month at the Pharmacy Management National Seminar for England, he warned: “We have a system where 50 per cent of people with long-term conditions stop taking medicines within one year, but we glibly go on thinking that’s alright.”
Dr Alessi believes that a closer relationship between the NHS and the pharma industry would be a good thing, and that the challenges in working together simply needed to be faced with honest and open discussions.
“Pharma should love medicines optimisation,” he went on. “But to change [the current situation] will require pharmacists to move outside of their zone of comfort.”
In a nutshell, medicines optimisation is about getting value for money for taxpayers and better outcomes for patients. Reducing waste – particularly with the NHS likely to be under continuing financial pressure – is a crucial part of that.
Dr Alessi suggested that doctors should concentrate on diagnosis and treatment planning, with pharmacists left to get on with the day-to-day job of managing medicines in long-term conditions.
As the “most accessible of the healthcare professions”, they must play a key role with patients, Dr Alessi said, but their accessibility also means that pharma should be able to form with them the long-term relationships that underpin the medicines optimisation agenda.
He added: “It’s a difficult discussion [for pharmacy] to have with the pharmaceutical industry – the business model is not entirely broken, so it would take a really brave managing director to change.”
This is especially true given that risk-sharing agreements could potentially see companies lose money, Dr Alessi acknowledged.
Speaking at the same seminar, Peter Rowe, formerly the Department of Health’s national QIPP lead for medicines use and procurement, agreed that “the NHS must work with pharma to better monitor patient outcomes”, leading to better and more cost-effective care.
Bemoaning the fact that there had not been as much progress on medicines optimisation as had been hoped, he warned that more needs to happen because there will be twice as many 80-year-olds fifty years from now, and “we haven’t yet worked out how we will deal with this demographic time bomb”.
To illustrate the point about austerity in the NHS, he said that one Clinical Commissioning Group is starting the financial year with an £18 million deficit, despite the former Primary Care Trust having started the prior year with a surplus.
“Things are not looking good for this year,” Rowe added.
The government has been keen to recruit pharma to the medicines optimisation cause, with chief pharmaceutical officer Keith Ridge insisting the industry will have a key role to play.
Referring to the programme that preceded it, Ridge has insisted that medicines optimisation will not be “medicines management re-packaged”.