As the Health and Care Bill begins its journey through parliament, how will structural changes to the NHS landscape influence brand planning within pharma companies?
Earlier this summer, the government introduced the Health and Care Bill in parliament. It confirms much of the detail in the original White Paper and begins the process of putting the changes being made to the structure and governance of the NHS on a statutory footing.
Nothing will be quite the same
The proposed legislation marks out a series of departures from a consensus around how the NHS operates that stretches back to the 1990s. The substance of these reforms is well-known, though the full implications for industry are still being grasped.
In place of the provider-commissioner split, there will be integrated care systems (ICSs), and in place of competition and tariff-based funding, there will be a new generation of networks, governance structures and relationships – all designed to foster collaboration across health organisations.
For pharma, this means that nothing will be quite the same again – not least when it comes to brand planning, which must now rapidly adapt to some significant changes to access arrangements and decision-making across the NHS landscape.
Three direct implications for pharma
Reconfiguring engagement strategies
The first involves recognising the reality that healthcare professionals (HCPs) in provider organisations will increasingly be making collective purchasing decisions at a system level.
It will therefore no longer be enough to zero in on a select group of favourable key opinion leaders (KOLs) to maintain your market position. The modus operandi for engagement and customer relationship management will need to broaden – not just consolidating support of your advocates, but influencing a wider selection of decision-makers across a system.
Adapting and optimising commercial operations
Second, the reforms involve a significant move towards greater integration at three levels – system, place and neighbourhood – which will present a major organisational challenge to pharma companies.
Organising field teams around outdated territories, or basing engagement around ‘hospital specialisms’ is unlikely to mesh effectively with the changing pattern of decision making across the NHS landscape.
There is a training challenge, too, in terms of enabling cohorts of pharma staff to manage engagement at system, place and neighbourhood levels, and to get under the skin of the context in which these new decision-making units operate.
A more layered approach to market access
A third critical issue involves the new structure and composition of formularies.
We are starting to see a considerably more layered, complex environment for market access, with ICS formularies at system level and ICP formularies making decisions at place/neighbourhood level. Regional Medicines Optimisation Committees, operating at a level above system, will also issue voluntary guidance that may influence local decision-making.
Understanding the composition of these formularies and the context within which they make decisions will therefore become an increasingly important part of developing a
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