This blog is adapted from a speech given by Darren Stenlake, Chairman of BIVDA, to the All-Party Parliamentary Group for Life Sciences as part of the ‘Understanding the value of new medicines and diagnostics in the NHS’ event, on 16 May 2019.
In vitro diagnostics, or IVDs, are an essential part of the NHS. They are used to both diagnose and rule out causes of ill health. They are also used to monitor, screen and assess people for any potential health problems they may have. More than ever before, they allow people with chronic disease to manage their own conditions and, in the context of molecular tests, they can determine vital information about a patient or an infectious agent’s genetic make-up.
Effectively used, IVDs can help reduce hospital stays, support patients to look after their own health and release resources for use elsewhere in the NHS. These benefits, combined, not only result in a healthier population and stronger economic growth, but also a more efficient use of NHS resources. 900 million tests are carried out every year in the UK and some 2 million units of donated blood are screened for infectious disease using diagnostic tests to enable safe transfusion into patients. Crucially, over 70% of clinical decisions depend on the results of IVD tests. Yet, the NHS spends approximately £820 million annually on IVD products, less than 1% of its total budget. And IVD per capita expenditure in the UK is one of the lowest in Europe.
Looking ahead, our industry will continue providing important benefits to both UK patients and the NHS. But the large disparities between where we are now and where we need to be need to be addressed. Over the next 10 years, for example, there will be a 10% per annum increase in demand for blood and tissue tests due to a growing, ageing population and rising incidence of chronic disease. And with the future of healthcare focused on personalising medicine and ensuring the right person gets the right treatment at the right time, innovations in diagnostics will be critical to achieving this ambition.
However, the sector still faces a glass ceiling when it comes to the uptake and diffusion of IVDs within the NHS. Many of these IVDs are recommended by NICE and there is strong evidence that using these tests could save the NHS significant sums of money, whilst also benefiting the patient. But there is no mandate or dedicated funding for their use and, widespread adoption of new diagnostic tests currently takes about 10 years. Also, as it stands, the budget for testing and general pathology in the NHS is separated from the rest of the budget for a medical pathway. This often serves as a disincentive to introduce cost-saving and potentially life-saving new tests because very often the savings accrue further down the patient pathway. Another issue the industry faces is that related to the understanding of new tests and technologies. When being commissioned, the benefits of diagnostics are often either misunderstood, or worse, not considered at all. And finally, inflexibility within the system as solutions are still often thought of in terms of pharmaceuticals and consideration is not often given to how IVDs could be adopted in the system to improve outcomes.
One of the key solutions that industry has been calling for is for IVDs to receive the same status as medicines, specifically by making it mandatory that positive NICE Diagnostics Guidance is funded and implemented within 90 days.
Also, there is now an opportunity to tip the scales with initiatives such as the newly-boosted Accelerated Access Collaborative which, with the right focus can not only benefit industry, our economy and the NHS but, most importantly, patients. This has already started to generate some early results in that three of the seven proven innovative technologies identified to help improve patients’ lives are IVDs. What is clear is that we must now work together to successfully capitalise on the opportunities ahead and that building a vision for the future will require collaboration and a framework capable of truly driving and fostering innovation adoption.
The All-Party Parliamentary Group for Life Sciences is chaired by Daniel Zeichner MP. The vice-chair is Chris Green MP. The APPG officers are Lord Patel, Lord Turnberg and Lord Warner. The Association of the British Pharmaceutical Industry (ABPI), the BioIndustry Association (BIA) and the British In-Vitro Diagnostics Association (BIVDA) jointly provide the secretariat.