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  • The Freeman Review: the silver bullet?

    The Freeman Review: the silver bullet?

    After a lengthy delay, Jeremy Hunt has finally announced that the Innovative Medicines and Med Tech review will be led by Sir Hugh Taylor, chair of Guys and St Thomas’ NHS Trust, and supported by an expert advisory group to be led by Sir John Bell, Regius Professor of Medicine at Oxford University.

    Sir Hugh Taylor appears to be the smart choice to lead this review. He is well respected by NICE and many of the other regulators, and is considered a friend to industry. The same could be said of Sir John Bell, although it is questioned how enthusiastic Sir John was about taking on the role, and whether his inclusion in the review is the direct result of pressure from No10. There have been numerous delays to the announcement of the review’s leadership and terms of reference, and there are rumours that Cameron’s health advisor Nick Seddon has been applying increasing pressure in recent weeks to get it over the line.

    The terms of reference outline three key areas for potential reform; Regulation, Reimbursement, and Uptake. Regulatory change should be an easier win with bodies like the MHRA increasingly open to change. This is exemplified by the MHRA’s decision today to allow doctors across the country to prescribe unlicensed melanoma treatment pembrolizumab as part of the Early Access to Medicines scheme. However, uptake of new treatments by conservative prescribers will always be the toughest nut to crack.

    The review will consider the ‘long term landscape’ including how the controversial Cancer Drugs Fund, PPRS and Value Based Pricing schemes may or may not fit into the integrated specialised commissioning system of the future. With a second round of de-listing from the CDF expected in April, it is clear that the Government needs to do something to demonstrate that the UK is still committed to life sciences.

    As the NHS continues to be fought over by the main parties ahead of the looming general election, this review is one of few points that they all agree on. It has been endorsed by all three of the main parties, but that does not necessarily mean that political instability will not play its part in this process. A change of government is likely to stall progress, not least because we currently have no idea who will hold the life sciences ministerial brief post May.

    With Taylor and Bell at the helm of this review, and Sir Mike Rawlins as Chair of the MHRA, there could be a real opportunity to join the system up moving forwards. However, if there is to be any real progress, then industry, NICE, NHS England and the MHRA will all have to work together and meet in the middle to find a workable solution for all. This review in isolation is unlikely to be the silver bullet – industry will need to play its part in coming up with solutions, and prove that it is prepared, to an extent, to be flexible.

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