Life-saving medicines carry a big social footprint, yet filling the shoes of advocacy in support of the industry that produces
them can be a surprisingly solitary pursuit. Surveys reveal that the policy critics of Big Pharma are actually more numerous,
highly visible—and often better financed—than institutions with a more balanced view. What the industry does have in its favor
is the capacity to generate good evidence, particularly in response to claims that there are too few novel drugs that meet
real medical need; that drug design and development is imitative, not innovative; and that high prices bear no relationship
to risk. One example of productive engagement in this space is the UK Office of Health Economics (OHE) now celebrating its
50th anniversary as a policy research enterprise. Through a close founding relationship with the Association of the British
Pharmaceutical Industry (ABPI), OHE is linked to industry, but is not of it. Since 1962, the group—now with 15 professionals
on board—has produced more than 350 studies and publications and sponsored nearly an equal number of public meetings and events,
all with the goal of making discussions about medicines, health, and society truly objective, because it is based on objective,
verifiable evidence. Pharm Exec spoke recently with OHE director Adrian Towse—who has led the OHE for nearly 20 of those 50 years—about the many external
transformations that have shaped his work as well as his perspective on what the industry needs to prevail in an increasingly
contested fight for reputational advantage.
Fifty years is a long time to be continuously engaged in the debate over the appropriate role of pharmaceuticals in the management
of disease, as well as their larger contributions to society. What has changed in the content and flow of the issues—and what
themes remain immutable?
Towse: The OHE was founded in 1962, a time when health economics as a distinct discipline, capable of guiding policy on the basis
of objective, verifiable evidence, was still in its infancy. Back then, physicians made all the decisions and payers simply
paid the bill. There were no HTA institutions primed to demand that drug-makers justify their claims with evidence that can
be both technically complex and politically sensitive. Nevertheless, the essential questions we seek to address in healthcare
have remained remarkably constant. Just like today, health decision makers in the 1960s wanted to know how much to pay for
drugs—is there a "right price" that balances the requirement that innovators make a return on their investment with the need
for fair access to all patients who can benefit? How do you reconcile the notion of health as a public good with the mainly
commercial orientation of medical research? And finding ways to deliver health services more efficiently was just as important
then as it is today.
What has changed is our increasing ability to marshal the analytical tools and evidence that allow decision-makers to take
their questions to the next level. For example, we can not only tell payers how much an intervention costs, we can project
outcomes and advise them how to allocate expenditure efficiently, across disease areas to improve value for money.