New research published by the Association of the British Pharmaceutical Industry (ABPI) shows that the UK uses branded medicines less per person than many other countries but tends to use older rather than the latest medicines. This means that fewer patients in the UK are receiving new, innovative medicines than the average in a range of comparable, developed countries.
The report, International Comparison of Medicines Usage: Quantitative Analysis was compiled by the Office of Health Economics (OHE) and updates the 2010 Richards Report which examined the extent and causes of variations in international medicines use.
Despite showing an increase in usage per person for 11 of the 16 therapy classes surveyed from 2008/09, the report shows that the UK remains 9th out of 13 countries with France maintaining its position at the top of the rankings and New Zealand still 13th. In seven of these 11 classes the UK usage per person was below the international average for 2012/13 – this included the latest cancer medicines less than five years old and those for dementia, multiple sclerosis and stroke prevention.
In the remaining four of these 11 classes – cancer medicines more than 10 years old and medicines for osteoporosis, respiratory distress syndrome and wet age-related macular degeneration – UK use was higher than the international average for 2012/13, highlighting a reliance on older medicines and relatively slow uptake since 2009 of newer, more innovative medicines particularly to treat cancer.
David Watson, the ABPI’s Director of Pricing and Reimbursement, said: “Whilst this report highlights an improvement in ranking for the use of some medicines and a decline in just a few areas, overall the UK has remained static in the bottom half of the table which is disappointing given the number of initiatives in place since 2009 to improve patient access to newer medicines.
“The UK’s continued use of older medicines, especially to treat cancer and diabetes, highlights a failing in the system to ensure that patients benefit from the new, innovative treatments the pharmaceutical industry is developing to improve patients’ health outcomes. We are seeing NICE recommended medicines facing further review, restrictions and modifications compared to NICE guidance.
“For our part the industry has, through the 2014 Pharmaceutical Price Regulation Scheme (PPRS), agreed to keep NHS expenditure on branded medicines flat for two years and within agreed controlled growth levels for a further three years. This should enable the NHS to prescribe the newest, most effective medicines for patients and we would expect to see a rise in the per person use of some of these newer medicines in future years.
“We will use the information in this report to continue discussions between industry, the Department of Health and the NHS on how access to medicines can be increased through the commitments of the PPRS agreement.”
In five of the 16 classes of drugs measured the UK has fallen below the international average including: cancer medicines six-10 years old, hormonal cancer medicines, thrombolytics for myocardial infarction, TNF medicines for rheumatoid arthritis and statins.
This latest quantitative analysis of international medicines usage replicated the methods and medicines of the Richards Report and additionally included data on medicines for HIV and diabetes. UK usage of HIV medicines is in line with that of other countries; however, its use of diabetes medicine is about a third of that of other countries, close to the international average for insulin and significantly above the average for older diabetes medicines.
RAND has published a complementary report examining the reasons for variations in international medicines usage – International variation in drug usage: an exploratory analysis of the ’causes’ of variation.