1. The Future of Market
Access – The Patient
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Eric Low, CEO
Myeloma UK
29 November, The King’s Fund, London

2. My talk will cover…
• What do patients want from treatment
• An explanation of some of the barriers and
issues
• What needs t happen to improve the
situation

3. What do patients want from treatment?
Very individual – different patients will want different things
Choice?
Part of decision-making?
A degree of ownership/control
Quick fix?
Maximum disease control?
Oral at home treatment or hospital based?
Convenience?
No/few side-effects?
Long durable remissions?
Accessible when needed……
Fair pricing………..

4. Challenges and Barriers
• Poor inputs give you poor outputs….
• There are significant limitations in the data generated on
which appraisals and ultimately access are made
• We need to think carefully about what constitutes
appropriate evidence and do a better job of producing it
• We need to think beyond phase III registration study's
towards broader and more relevant real-world data
• We also need to consider adaptive approaches to
licensing
• We need to align the evidence needs of regulators,
industry, HTA, payers, doctors and patients….

5. Challenges and Barriers
• Some new medicines have an unjustifiably high
price and this leads to access issues
• We need new approaches to pricing and more
sophisticated ways to assess value and
therefore be sure that the price paid is fair to all
• Industry should be more transparent and honest
about how their medicines are priced – patients
do care and increasingly have access to the
information they need to advocate

6. Challenges and Barriers
• Current commissioning policy falls short denying patients access to
best treatment
• Bias towards commissioning of commercial data in treatment
pathways
• No way to include other evidence domains such as academic
research, consensus of expert opinion and real-word data
• Stifles clinical innovation
• Reactive and out of date rather than proactive and in time
• Doesn’t reflect heterogeneity of disease and patients
• Probably does not deliver cost effectiveness/efficiency
• Access is different from volume uptake and is often confused
• As a consequence there is a weak demand side which incentivises
continued mediocrity on almost all levels

7. Challenges and Barriers
• Policy is often not fit for purpose – this
impacts on access
• PCT barriers
• Individual funding requests
• Cancer Drugs Fund
• Patient Access Schemes
• Numerous bench to bedside policy
conflicts

8. Solutions – a new model?
1. Stop working and thinking in silos
2. Personalised medicine and
companion diagnostics
3. Better trials better evidence
4. Adaptive approaches to licensing
5. Broader assessment of value at HTA
level and a formal price discussion
6. Disease-specific whole pathway
modelling
7. Create demand side for academic
and commercial research
8. Collect performance data against a
set of KPI’s and report back
9. Integrated HSR
10. Involve and think about patients
across the whole pathway and
back….