The 2012 Health and Social Care Act dictated far-reaching changes to the structure and authority of the NHS. These changes are currently coming into effect, with the introduction of value-based pricing due next year.
For pharmaceutical companies operating in England and Wales, the new powers given to the NHS’ regulatory body NICE call for a rethink of pricing and reimbursement strategy.
At the local level, in the area of payer and provider engagement, there are both challenges and opportunities for market access departments. The industry is still assessing the impact of the abolition of NHS Trust and the ongoing establishment of its successor, the Clinical Commissioning Group or CCG.
Effective navigation of the altered payer landscape will depend on a good understanding of the structure of this new organization.
Understanding the Clinical Commissioning Group
- All GP practices are members of a CCG, and there are 211 CCGs controlling a budget of around £65b in England.
- Every CCG has a constitution which details how it is structured, populated and run; this is the most important document to obtain in order to understand how the body operates.
- The constitution contains information on all members of the CCG including the governing body, or board. The governing body will publish minutes of meetings, as well as details of the contracts it signs.
- Every CCG will have a Clinical Lead, supported by other healthcare professionals with diverse therapeutic specialisms.
- Not all CCGs are the same. Depending on the level of expertise available, some will receive commissioning support from NHS England or CSUs (Commissioning Support Units). Others will be entirely autonomous.
How BaseCase can promote effective communication with CCGs
Presenting economic arguments
These structural changes to the NHS come at a time of rising economic pressure on the UK’s public health system. While Prime Minister David Cameron promised real-term increases to the NHS budget, the rising cost of treatments and a rapidly ageing population mean that in practice the organization must make significant cost reductions.
The communication of an economic argument is therefore an essential component of engagement with budget holders in the ‘new NHS’, and BaseCase is designed expressly for this purpose. Our UK clients can use the platform to create customer-specific apps that present a budget impact model or health outcomes data in an intuitive and interactive way.
With an increasingly fragmented and rapidly evolving payer landscape, flexibility is important. If circumstances require a change to the value story, it should be possible to achieve this without a large investment of time and effort.
When a vendor is employed to develop an iPad app for a value story, it’s quite challenging to modify that tool at a later stage. The time and cost involved with reprogramming the software normally means that field staff are left using an increasingly imperfect or outdated tool.
By contrast, BaseCase is designed to support customer engagement in a changing marketplace. The platform enables market access teams to develop apps that are specific to each customer, without hiring programmers. If anything changes, or a new strategy is preferred, they can log in to the platform and update the app with the drag-and-drop editor.