Sally Gainsbury
@sallygainsbury.bsky.social
1.8K followers 390 following 140 posts
Senior Policy Analyst for the Nuffield Trust, writing and doing whatever-things-on-here-are-called about NHS funding, finance and healthcare equity
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sallygainsbury.bsky.social
Patent protections mean pharma cos can set prices high. The VPAG agreement at the centre of the row offers the NHS a modest counterbalance against those high prices when sales volumes exceed expectations and already contains exemptions to allow companies to recoup their R&D costs
sallygainsbury.bsky.social
There is mounting evidence that rather than being “too low” the NICE threshold (the max the NHS will pay for a yr of health gained through a drug) is currently too high as it outstrips how much health could be gained if the £ was spent instead on extending existing services >
sallygainsbury.bsky.social
Key points: Big pharma’s threat to pull investment from the UK if the NHS doesn’t pay more is based on politics, not economics. Industry’s own research shows that decisions on R&D location are driven by where you can do good science, not local market prices for the end product >
sallygainsbury.bsky.social
Trump and pharma are lobbying gov hard to water-down the NHS’s ability to contain spending on new branded drugs. Today’s long read from me and the LSE’s Huseyin Naci sets out why the gov should hold firm to protect the health of the NHS and UK public nuffieldtrust.org.uk/news-item/th... >>
The tough choices at the heart of the government’s dispute with big pharma
The government has been locked in a dispute with pharmaceutical companies for a number of months over how much the NHS pays for new branded medicines. Sally Gainsbury and Huseyin Naci set out the issu...
nuffieldtrust.org.uk
sallygainsbury.bsky.social
interesting. I wonder if the catch up at 16 seen in the overall dashed ECHP line is a genuine improvement in outcomes, or rather a widening of who is included in that cohort to include those whose edu outcomes were higher/likely to be slightly higher already?
sallygainsbury.bsky.social
this is really interesting Luke, thank you. It seems to suggest that educational outcomes (measured by the standardised score) have improved since ~2015 for the older kids on ECHPs, but declined for the younger. Or am I misinterpreting that?
sallygainsbury.bsky.social
But the gov hasn’t made things easy for itself with its rhetoric around the NHS as an engine of economic growth (rather than the quaint notion it is there to improve our health)>>
sallygainsbury.bsky.social
If the gov pays more for new medicines, we are highly likely to get LESS health benefit out of the NHS, not more. It’s right the gov holds firm and considers population-wide health needs rather than bow to industry threats and scare stories >>
sallygainsbury.bsky.social
It’s correct the £30k threshold has been in place since the late 1990s, but ample economic research shows it is likely too high rather than too low >>
sallygainsbury.bsky.social
This isn’t penny pinching: the threshold exists in order to ensure expensive new drugs don’t displace pre-existing treatments, because the nhs can only spend its budget once >>
sallygainsbury.bsky.social
Sometimes new drugs fail that test simply because they are very expensive. Other times they fail because their price might be modest, but the health improvements they offer above already existing treatments are extremely marginal >>
sallygainsbury.bsky.social
The nhs (via NICE) generally requires that for a new drug to be adopted, the extra health benefits it brings should not add more than £30k above existing treatments for that disease >>
sallygainsbury.bsky.social
The 10 year nhs plan already sets out a terrifying raft of concessions to pharma and med tech to try and convince them to invest in the uk to feed the political addiction to economic growth >>
sallygainsbury.bsky.social
PSA that the purpose of the #NHS is NOT to provide investment opportunities or lucrative income streams for the pharmaceutical industry #r4today >>
sallygainsbury.bsky.social
Editorial from me and LSE’s Huseyin Naci on the government's bid to use the NHS as a means to attract more med tech and pharma investment into the UK. TLDR: great for profits, less great for getting the most value for patients out of the NHS www.bmj.com/content/390/...
sallygainsbury.bsky.social
The quaint idea the #NHS exists to improve health has been supplemented with the idea it can also drive economic #growth. My thoughts on the gamble the gov is making by inviting in more tech- and pharma- and whether we’ll end up with less as a consequence: www.nuffieldtrust.org.uk/news-item/an...
www.nuffieldtrust.org.uk