Introduction“Joint-working” between the pharmaceutical industry and the NHS has emerged as a high-profile policy initiative in the United Kingdom (UK). Spearheaded by the Department of Health (DH), ABPI, and other stakeholders, this agenda has been influenced by the NHS quality/productivity drive, which has increasingly prompted health-service managers to consider external support as a means to plug the resources gap.

ObjectivesThis study sought to characterise the current landscape for Joint-working in the UK by surveying the types of projects being undertaken by industry and the NHS.

MethodsThe websites of major pharmaceutical companies, NHS organizations, and other stakeholders were consulted to create a list of joint-working projects documented in the public domain. To qualify as a joint-working project, collaborations had to involve a sustained commitment from industry beyond traditional sponsorship. A classification system was then devised to segment projects. Finally, the resulting database was then analysed to ascertain qualitative and basic quantitative insights into the UK joint-working environment.

ResultsA total of 165 joint-working projects, involving 37 pharmaceutical companies, were identified; of these, 129 (78%) involved a single pharmaceutical company and 36 (22%) involved multiple industry partners. Large, multinational, innovator pharmaceutical companies appear to be the most active industry participants in Joint-working (Figure 1). Smaller entities tend to enter multi-company projects, while this breakdown (single/multi-company) varied across the large players (Figure 1).

Figure 1. Number of NHS joint-working projects by pharmaceutical company Source: IHS secondary research

The Respiratory TA dominates UK Joint-working, accounting for over a quarter of the identified projects (Figure 2). The majority of these (39 in total) correspond to chronic obstructive pulmonary disease, with five dedicated to asthma and one to both indications. Of those projects pertaining to specific indications or TAs, the companies participating in them hold assets in the corresponding areas as a general rule; however, Multiple TA initiatives (e.g., medicines review or waste-management programmes) make up 9% of the total identified projects.

Figure 2. Segmentation of NHS joint-working projects by therapeutic areaSource: IHS secondary research

In terms of classification, those projects identified uniquely as Service Development initiatives accounted for the largest single category, at 25% (42 projects) (Table 1). To ascertain whether a correlation between Respiratory and Service Development projects was driving this finding, projects were jointly segmented by TA and category (the latter on a “double-counting” basis where there were multiple category assignments). Each TA/category pairing was then expressed as a percentage of the total number of projects in that TA. The results indicate that Service Development projects are common across prevalent TAs, and that this category does not in fact account for the highest percentage of Respiratory projects.

Table 1. Categorisation of NHS joint-working projects Source: IHS secondary research

ConclusionsWhile involvement from the TA perspective tends to align with company portfolios, there is evidence that multi-company projects—often centered broadly on medicines or multiple indications—account for a considerable share of Joint-working, indicating that objectives other than direct market access influence industry strategy in this arena.

While the trends observed here will have been influenced by the extent of, and any biases in, individual company disclosure of joint-working projects, it appears that the Respiratory TA dominates the UK joint-working landscape by some margin. The dominance of this TA and prevalence of certain others (e.g., Metabolic and Cardiovascular) may, in addition to reflecting the UK disease burden, also relate to the impact of the QOF, an incentive scheme that rewards practitioners for service achievements across these areas. Projects enabling managers to meet these targets may have helped boost the uptake of these initiatives. Existing research suggests that these TA trends are broadly in alignment with NHS needs, although there may be greater demand for projects centered on LTCs.

“Other” includes allergy, central nervous system, dermatology, drug addiction, long-term conditions, nephrology, nutrition, ophthalmology, smoking cessation, urology, and vaccines

Project category Number (Percentage of total)

Service Development 40 (27%)HCP Education 26 (16%)Service Optimisation 21 (13%)Patient Education 17 (10%)Screening 14 (8%)Capacity Support 15 (9%)Guideline Implementation 14 (8%)Guideline Development 12 (7%)Service Audit 11 (7%)Commissioning Support 11 (7%)Awareness Raising 7 (4%)Medicines Review 4 (2%)Unidentified 2 (1%)Publication 1 (1%)

A Survey of “Joint Working” Between the Pharmaceutical Industry and the National Health Service in the United KingdomLockwood C, Marinoni G, Ando G (IHS, London, United Kingdom)

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