Evidence It's a Myth That Medicine Budgets Are under Pressure Is Good News for Patients; Medicines Are Set to Become Cheaper Than Ever in the UK. Dr Richard Greville, Director of the Association of the British Pharmaceutical Industry Cymru Believes That Wales Now Has a Once-in-a-Generation Opportunity to Improve Access to Life-Saving and Life-Changing Drugs
Byline: Dr Richard Greville
THE affordability of medicines and the availability of new treatments to those who need them most are of obvious concern to patients, carers, health professional, politicians and the public in general.
These concerns are often driven by the belief that NHS Wales cannot afford an ever-increasing supply of new medicines - regardless of the benefit to the individual.
However, we are entering an exciting period of opportunity, which should allow a fresh look at the availability of new medicines for the people of Wales.
The notion that there is not enough money to pay for new medicines has repeatedly proven wrong, with medicines making up a smaller and smaller part of the overall NHS budget.
In Wales, for instance, the pounds 563m spent on medicines in primary care during 2005-06 amounted to a little under 12% of the total expenditure on health - down from 14% in 2002-03.
Indeed, if the annual expenditure on medicines by LHBs is compared to the budget allocated to them by the Welsh Assembly Government, it is not uncommon to see an underspend.
For example, in 2007-08, 20 of the current 22 LHBs appear to have chosen to underspend their allocated medicines budget.
It is therefore a myth that medicines budgets are under unsustainable pressure.
While people in Wales are being denied access to modern medicines that enhance and prolong life, they are readily available in other European countries, where prices - and spending - are higher.
Wales spent pounds 220 per head of population on medicines in 2007, compared to France, where they spent pounds 322, and Ireland at pounds 260.
It has been estimated that the current spend in NHS Wales on statins - which help lower cholesterol - will save pounds 54.1m in hospital costs and pounds 3.5bn in wider economic benefits.
The question remains therefore as to whether more could be achieved in Wales with a more progressive approach to new medicines.
The discovery and development of new medicines is a very expensive journey, taking many years and involving thousands of people.
The development phase of a new medicine can last between 10 and 12 years and cost in excess of pounds 500m. It is at the beginning of this development time that the pharmaceutical company will apply for a patent.
Once in place, this patent gives the company the right to exclude others from making, using, offering for sale, or selling the new medicine. In other words, no other pharmaceutical company can create the same medicine in its laboratories and profit through it.
Although patents last for 20 years, many of these protected years are lost before a sufficient evidence base has been gathered to be awarded a licence and before the medicine becomes available to be routinely prescribed.
The opportunity available to recoup development costs and earn a profit is therefore limited to the time between the award of licence and the end of the patent's life.
After this time, the medicine is subjected to intense competition as generic versions - manufactured by companies who have not had to invest money into development costs - become available, often at significantly reduced cost.
In the next three years seven of the current top 20 prescribed branded medicines will fall off patent and will be replaced by much cheaper generic drugs.
This will lead to a huge change in the cost of medicines - it has been estimated that the NHS across the UK will save pounds 2.9bn over the next five years.
In Wales this will equate to savings of around pounds 160m.
There is further good news for NHS Wales. In addition to the savings accrued from medicines falling off-patent, a recent re-negotiation in the price of branded medicines means that they will become even better value for money.
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