Hasn't the scale of the challenge in delivering healt care services at reasonable cost increased since 1962? Annual outlays
for the National Health Service (NHS) have risen from less than £1 billion in 1962 to £125 billion today.
Towse: Costs have indeed increased, both in real terms and as a percentage of GDP, which is why there is a bigger focus today on
proving value for money. Economists possess the tools to do that, through sophisticated quality of life measures that allow
us to build a patient centred definition of value, by services and treatments delivered and from large cohorts of the population
down to the level of the individual patient. These expanding capabilities, in my view, can alleviate some of the pressures
on the innovative industry from the current round of fiscal austerity measures here in Europe—without the ability we now have
to quantify cost savings and realized value from the use of medicines, the impact of the economic crisis on drug spending
could be far worse.
Would you describe this work on valuing a drug the key progress metric for the profession over the past 50 years?
Towse: It is an important milestone in understanding how we fund and allocate scarce healthcare funds. The OHE was a pioneer in
the development of methodologies to help payers assess the impact a particular intervention has on the root question that
should drive all health spending: is the patient better off, and, if so, how does this translate to broader outcomes and savings
to the system overall? We convened our first expert meeting in the United Kingdom on drafting quality of life measures back
in 1983. This led the development of the EQ-5D and EQ-VAS patient scoring profiles that, for example, the NHS uses in its
Patient Reported Outcomes Measures [PROMS] data set on elective surgical procedures, launched in 2009 and now being expanded
to many additional procedures. As a result of this work, there is now much greater acceptance by payers of the usefulness
of patient-reported outcomes. This is crucial to valuing drugs.
How has OHE kept pace with the transformation of healthcare over the past six decades?
Towse: We have reinvented ourselves several times, but the most important change is the broadening of the OHE's focus—to issues
beyond the narrow purview of pharmaceuticals, and with a perspective that is global, no longer limited to the United Kingdom.
Both changes reflect the evolution of the industry itself, which today sees itself as a "partner" in healthcare across multiple
markets. All the issues that drug companies face are now global. For example, you cannot build a coherent approach to HTA
without recognizing that these new regulatory institutions are highly networked, and obtain their evidence from many sources
outside their own jurisdictions. The emphasis on sharing practical solutions to health challenges has also motivated our expansion
into consulting as well as research. Advising and project work for clients—both public and private, and within and outside
the United Kingdom—has made us a self-sustaining enterprise.
Who are the OHE's principal sponsors?
Towse: Our membership and client base is increasingly diverse. We no longer depend exclusively on funding from the Association of
the British Pharmaceutical Industry [ABPI], which gave us our start in 1962 and continues to be a strong supporter. Half of
our annual budget now comes from organizations outside the industry. Public and private clients—including emerging market
countries such as Brazil and China—are driving a big portion of the consulting practice we launched in 2002.