According to preliminary 2023 data, life expectancy at birth in the EU was 81.5 years, up by 0.9 years from 2022, and 0.2 years compared with the pre-pandemic level in 20191. Over the years, the steady increase in the population living longer has, in part, been helped by the development of new medicines, vaccines, and treatments that can tackle some of the leading causes of disease and life-threatening illnesses. However, these developments can create additional burdens on the NHS and ultimately the patients it serves.
During this period of rapid change and innovation, many patients are not benefitting from that innovation because these new medicines are either unaffordable, inaccessible, or unavailable through ongoing supply shortages. In fact, national shortages of medicines have become an increasing concern, contributing directly to health inequalities. If patients are unable to access the medications they need, this can result in avoidable health complications.
In addition, the increased therapeutic benefit of costly medicines is not always proportionate to their added cost and their effect on the patient’s overall cost of treatment. In the UK, this results in not only a growing challenge for national budgets, but to individual patients as well.
Generic medicines can play a critical role in healthcare systems by making essential medicines more affordable. According to NHS figures (NHS Digital), more than one billion items are prescribed generically in the UK every year. They represent 75% of all NHS prescriptions, and introduce competition to the supply of medicines, which is a significant factor in lowering medicine prices for off-patent products. The increase in generic prescriptions, allied with a reduction in the net ingredient costs, means that overall savings to the NHS’s medicines bill have now passed more than £13 billion annually 2. Prescriptions for generic medicines can also help to ensure the financial viability of local community pharmacies, which in turn helps reduce the costs of medicines in the NHS.
The ongoing supply shortages are, of course, not a new phenomenon but the demand for certain medicines has surged globally in recent years. Manufacturing facility delays or shutdowns, issues with transportation, and geopolitical conflicts are all examples of factors that can affect delivery.
Supply shortages are directly linked to health inequalities. These supply issues must be addressed at a systemic level. This means creating contingency plans for national shortages and investing in generic and branded generic medicines where possible to ensure a steady supply of essential medications. Of course, aligning medicine procurement with patient needs, rather than solely with cost-saving measures, will also help prevent disparities in access.
There are many key factors facing the NHS today, including not only an aging population but also a lack of investment in the healthcare system, particularly for generics, branded generics, and biosimilars. The lack of investment is in direct contrast to investments made in other EU countries; hence the UK is less appealing for the generics sector to operate in.
Additional challenges with recent increased regulatory backlog in granting licensing applications, has meant that new generic medicines are not available to reduce costs to the NHS. By working with a range of key stakeholder groups across government, the medicines regulator, the MHRA, and commissioners, the industry can help ensure accessibility to the right medicine at the right time.
As leaders in the pharmaceutical sector, we help play a key role in understanding the broader dynamics of medicines and can refocus our efforts on interventions that will improve health outcomes for patients over time. Not all change requires financial investment.
We can also help steer stakeholders – including non-clinical leaders and community pharmacists – towards a model of care that focuses on prevention and long-term patient benefits, rather than just short-term cost savings. With patients often disadvantaged because they do not know how to navigate the system, healthcare professionals too have a role - not just as dispensers of medication but as navigators and advocates for patients within the health system.
Generic and branded generic medicines are crucial to the NHS because they make medication much more accessible to the wider population. As effective alternatives to branded products, generics can be used with a significantly reduced cost. Patients can have access to high-quality products within budget, boosting the effectiveness of the healthcare system, but only if there is a greater acknowledgement of the need for greater investment.