ABPI Cymru Wales Special Bulletin Edition WINTER 2019 Edition 23 The NHS and pharmaceutical industry working together to transform patient care – Welsh NHS Confederation Conference 2019

Wales should aspire to nothing less than a health and care system that delivers the best patient outcomes. We believe that strong partnerships between NHS Wales, patient organisations, academia and the pharmaceutical industry is the best way to improve outcomes for patients now and in the future.

Together we can: ABPI President Erik Nordkamp has made collaboration the focus of his presidency  Deliver ambitious, scalable projects that improve patient outcomes, create efficiencies During an interview setting the focus services and deliver the efficiency within the NHS and reduce for his Presidency in 2018, Erik said: and productivity so urgently needed. health inequalities for people “Today, we are able to prevent, By being involved at the earliest across Wales manage and even cure diseases in possible stage in strategic planning,  Create an innovation-ready ways we couldn’t have imagined we can work with the NHS and NHS that can embrace new in years past. Healthcare is Governments to make sure that UK approaches to prevention transforming, and much of the patients receive world-class care at and treatment transformation is being made the cutting edge of what is possible possible by medicines. today and in the future. Recognition  Make the best use of data of the role of medicines and new to enhance NHS research The pharmaceutical industry is proud technologies, as well as a commitment capability, generate real world to have been a partner to the NHS to encourage the discovery of evidence and allow the value throughout its 70-year history. The innovative medicines and their use in of innovation to be more industry’s collaboration with the UK the UK, would be transformational fully understood Government in producing the Life for patients, the NHS and our Science Industrial Strategy has set the economy. This must be our goal.” right tone of partnership and agenda The current ABPI President, Erik setting. Now, as we look to the health This special edition of the ABPI Cymru Nordkamp (Pfizer UK), reiterated challenges of the future, our industry Wales Bulletin brings together some the importance of collaboration – must play an integral role in long- of the projects we’ve covered over making it the focus of his presidency; term planning for the NHS. the last few years; this is just the tip helping to transform patient care of the iceberg – and our members through improving access to new “Our dedicated scientists and are working across Wales in many medicines and vaccines and ensuring academics can contribute solutions therapy areas. that Britain holds on to its status as and demonstrate how new a world leader in global medicines technologies and medicines can discovery now and post-Brexit. improve patient outcomes, transform

Page one ABPI Cymru Wales Bulletin WINTER 2019 Edition 23 Metastatic Breast Cancer (MBC) – Velindre NHS University

Trust and Novartis Working Together (first published Summer 2018) The Velindre Cancer Centre provides services to over 1.5 million people across South East Wales and beyond. Each year the cancer centre treats over 5,000 new referrals and around 50,000 new outpatients.1

The first year of the project has seen the achievement of the following outcomes: ◗ Improvement of the clinical • A reduction has been journey for oral SACT patients: demonstrated in overall patient • Trust-agreed Non Medical waiting times from arrival at Prescriber (NMP) Oral SACT hospital to departure with oral Guidelines have been SACT medication. Data shows Members of Velindre NHS University an average of 1hr 18 mins Trust and Novartis; Working Together implemented into the dedicated oral SACT clinics within the NMP-led clinic compared to 2hrs 19 mins Metastatic Breast Cancer (MBC) • A database has been within the consultant-led clinic. created that will capture: patient numbers are increasing along ◗ Improvement of MBC patient care: with the number of treatment options.2 – the number of oral SACT To ensure treatment optimisation the patients seen in clinic • Establishment and delivery of an MBC patients require holistic support. per week oral SACT dedicated outpatient This can be provided through different clinic for patients initiated onto – the percentage of oral models of care depending on their an oral SACT and a dedicated SACT patients accessed needs with a key patient support telephone service for patients in the new pharmacy-led clinic worker such as a Non Medical have been put in place. Prescriber (NMP) pharmacist. – the number of patients • All patients on oral SACT receive who have received an education on treatment and how The Velindre Cancer Centre MBC education review service did not have the level of to manage toxicities, and toxicity resource required to support a service – the number of patients who assessments as required. development that would ensure received a toxicity assessment • Patient survey shows patients receive this holistic support – the number of patients improvement in patient and achieve treatment optimisation. where a prescriber has been experience, adherence This identified unmet need led to contacted to clarify any issues. and concordance. the development, and implementation, of the two-year joint working project (JWP) between Novartis and In addition to these successful funding; utilising the evidence Velindre NHS University Trust to outcomes, the MBC project team created throughout the project, develop the Metastatic Breast shared learnings with the Royal and ensuring a sustainable service Cancer (MBC) Service. United Bath oral SACT clinic, the NHS continues at the end of this JWP. Grampian Melanoma oral SACT clinic The JWP started in December 2016 and the NMP forum with the British • Velindre Team: Ms Bethan with clear aims and objectives that Oncology Pharmacy Association Tranter, Chief Pharmacist; sought to ensure treatment (BOPA). The MBC project team have Dr Annabel Borley, Consultant optimisation for MBC patients within also been successful in submitting Oncologist and Clinical Lead; the Trust by improving patient care a poster on the year 1 outcomes to Ms Sophie Harding, Lead through stratification of patients into the International Pharmaceutical Pharmacist; Ms Sarah Gorman, different models of care dependent Federation (FIP) World Congress in Senior Pharmacy Technician on their needs, increasing MBC September 2018 in Glasgow and patient concordance and adherence were recently shortlisted for the 2018 to therapy through additional support, • Novartis Team: Maggie Clark, Welsh Pharmacy of the Year awards. establishing oral Systemic Anti- Government Affairs & Access Cancer Treatment (SACT) dedicated The first-year outcomes of this JWP Manager; Sarah Rawcliffe, clinics and improving treatment have demonstrated the value of this Disease Area Specialist; John pathways for oral SACT MBC patients service development and with the Bowen, Disease Area Specialist; across South East Wales by adhering project moving into its second year, Vivek Basantani, Customer to local guidelines and links into the a key outcome will be to create the Relationships Team leader multi-disciplinary team meetings. business case for sustainable

1 www.velindrecc.wales.nhs.uk/about-us 2 www.velindrecc.wales.nhs.uk/sitesplus/documents/1087/Velindre%20Cancer%20Centre%20Annual%20Report%202014.pdf (page 9)

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The role of medicines in a Prudent NHS The conference also acknowledged that one of the challenges facing the NHS is to improve patient compliance with their medicines. One route to address this would be to work with patients and carers to improve their understanding of their medicines and the How Wales is getting importance of adherence, thereby encouraging self- management and avoiding it right with Prudent medicines wastage and unplanned hospital admissions. Healthcare (first published Spring 2017) Decision-making processes about the availability of medicines In autumn 2016, AbbVie worked with the Bevan Commission should look beyond the cost of to bring together the public, patients, policymakers and acquisition and allow greater healthcare professionals in Cardiff to discuss how the consideration of the value that Prudent Healthcare Principles were being put into practice. medicines can bring to the wider health and social care system. The day-long conference followed unnecessary and unplanned Going forward, translating the Bevan’s maxim of “from cradle to hospital care episodes. Services rhetoric of Prudent Healthcare grave” and looked at how Prudent and care pathways need to be into reality will require some Healthcare is being rolled out across designed to provide support clear actions, and suggestions age groups: older years, working around the patient as close to for further actions include: age, teenagers and young people, home as possible.  Introducing educational and early years.  Patient engagement, in decisions programmes for young people While the issues discussed as part around their own care and also to inform them of how best to of the four panel discussions varied, involvement in decisions about make use of the health service depending on life stage, three clear how services are shaped and and encourage them to make themes emerged: delivered, is a sentiment expressed healthy choices; at all life stages. Patients need  Early intervention, particularly  Reviewing the optimal time to feel empowered to challenge the role of education, and how this for intervention and access to and question decisions about can help to inform young people treatment and care in chronic their care and become genuine about making healthy choices disease management; partners in the decisions made and support them to navigate the about their treatment.  Designing services to healthcare system so they can get support and promote patients’ the right care at the right time in self-management; the right place. There is also a role for early intervention in chronic  Improving patient engagement disease management where in decisions about their care; access to treatment and care  Introducing a commissioning at the optimal time can improve system that can take into account outcomes, thereby reducing the value of an intervention, long-term costs to the NHS. including how improving patients’  Supporting self-management, compliance with, and self- in order to give the individual management of, their medicines a sense of control over their can improve their quality of life condition but also to reduce and reduce reliance on and pressure on the NHS and avoid demand for health and social care.

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Janssen, and NHS

Wales Joint Working Initiative (first published Spring 2018)

Welsh Government and NHS Wales wish to support increased joint working with industry, focused on delivering better outcomes for people in Wales, by improving the efficiency and effectiveness of services, in line with the principles of ‘Prudent Healthcare’. There has been rapid therapeutic database which can critically analyse being able to measure the impact of advancement in the treatment of the outcome data for patients with treatment on patient outcome and myeloma in recent years, which has myeloma and eventually all other quality of life, and to justify costs. For improved patient outcomes. However, haematological malignancies. As the first time, it will accurately record novel agent therapy comes at a high such, units should have access to detailed information on incidence, cost and long-term treatment of a database registering all patients treatment and survival rates from myeloma, which remains a chronic at diagnosis with data regarding myeloma and subsequently all incurable malignancy, remains highly their demographic features, disease haematological cancers across Wales. challenging. The aim should be to presentation/staging, diagnostic This will enable NHS Wales and the maximise patient longevity and quality features, treatment plan, response to Welsh Government to consider the of life through minimisation of the treatment and overall survival. Quality outcomes for approved medicines, short- and long-term damage incurred of life data may also be collected, making informed decisions about by both the disease and the medicines both to justify the cost and burden which treatments to invest in – or used to treat it. This requires scrutiny of treatment and to demonstrate stop funding. In addition, patients of patient disease burden and fitness the impact of treatment over non- can be provided with a more honest at diagnosis, together with response treatment from a patient perspective. assessment of what to expect from to treatment and its impact in terms treatment pathways based on real- of quality of life. This can only be Historically data capture for cancer world evidence data. achieved through systematic data patients in Wales has been through capture throughout the patient journey. the Cancer Network Information The database will also potentially give System Cymru (CaNISC) system. Motivated by a desire to move the Welsh Government the opportunity Designed for solid tumours, it is ill to gain access to medicines ahead of from a transactional approach to a equipped to capture the nuances partnership between Janssen and the other UK countries, as pharmaceutical of haematological diseases. It also companies will be drawn by the NHS, this project can be thought of as is not suitable for the requirements ‘commissioning for outcomes’. This is incentive of efficient data capture. of quality of life data capture or By having a robust system in place where investment by pharmaceutical treatment response. This un- companies in the health sector can that will allow pharmaceutical scrutinised treatment with high-cost, companies to propose patient take the form of both the means to potentially toxic drugs has inevitably access novel therapies early in their access schemes, NHS Wales and led to wasted resource and ineffective development, alongside support for the Welsh Government will have the treatment for some patients. resources, which will make these data available to make an informed Investment in data capture is urgently agents more cost effective and decision on what is best for patients required to reverse this trend. feasible to deliver. It was identified in Wales and ensure they are getting that haematology services in Wales The key benefit of implementing access to the best medicines, at the require an innovative and personalised a Welsh haematology database is best price, as early as possible.

Main Image: Launching the new initiative (l-r): , AM (Cabinet Secretary for Health and Social Services), Nicky Lilliott (Senior Director, Government Affairs & Policy, UK and Ireland, Johnson & Johnson), Lee-Ann Farrell (Government Affairs Manager – Wales & Northern Ireland, Janssen-Cilag Ltd), Mark Hicken (Managing Director, UK & Ireland, Janssen-Cilag Ltd) and , AM (Cabinet Secretary for Economy and Transport)

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Velindre Cancer Centre and Bristol Myers Squibb Pharmaceuticals Limited Immuno- Oncology Joint Working Project (first published Autumn 2018)

An example of the increased joint working and the frequency of hospital visits. In parallel an assessment of potential opportunities with industry in delivering future patient demand was provided better outcomes for people in Wales and by BMS’s Demand Assessment Model, informing the modelling of revised improving services for patients. pathways and resources. It is widely accepted that cancer IQVIA on behalf of BMS) which would As a result, next steps have been to centre environments and the help support the drive for continuous pilot an interim pathway that is more experience of treatment can improvement and deliver the best streamlined, creating a single point of affect patients’ anxiety levels – possible care for patients. contact throughout the pre-treatment which directly impacts on their Project design supported by an IQVIA process to provide continuity of care experiences and outcomes. project manager included mapping and test the concept. The project Patient feedback has led the the patient pathway. This delivered a closed in February 2018 and VCC Velindre Cancer Centre (VCC) powerful visual tool that identified the and Bristol-Myers Squibb have to consider how to better utilise management, routine investigation reflected that working together and available data to redesign services and process of administration of delivering the project yielded great treatment. By process mapping with to improve its patient experience. experience for both parties. key stakeholders it was possible Recognising that the physical to highlight inefficiencies within the The project exemplifies how NHS environment in which patients are pathway. A key area uncovered was and industry collaboration can cared for is becoming increasingly the duplication of effort by healthcare impact on patient outcomes as well busy, and with the incidence of cancer professionals, thus creating a as providing significant insight and rising in the Welsh population, VCC discussion point for the clinical teamed up with Bristol-Myers Squibb learning for both VCC and BMS, team to see the case for change plus the opportunity to share what (BMS) to find a solution for how to and engage HCP stakeholders. maintain patient experience and quality has jointly been achieved both at in the face of growing service delivery. Through stakeholder workshops, the national and international conferences. A project was developed alongside project team could analyse information In addition, the project has recently BMS to undertake a service redesign and make key recommendations for come runner-up in a Pharamceutical improvement. This innovative approach specifically looking at patient flow Field Award. through the Systemic Anti-Cancer was shared with the SACT service and Treatment (SACT) service. By entering the wider organisation. Main Image: Sam Otorepec, Project a Joint Working Agreement there The project delivered excellent Manager – Pathways Effectiveness was an opportunity to pool resources, outcomes, including a piloted service UK, Integrated Engagement Services, skills and expertise from both parties model aimed at reducing the burden IQVIA; and Phil Webb, Associate to examine the issues. This included on treatment assessment clinics and Director of Planning, Performance and access to data, service modelling and benefiting patients by reducing both Innovation – Velindre NHS Trust at the project management (provided by the time spent in outpatient clinics Pharmaceutical Field Award Ceremony

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Local campaign targets unused medicines and

incorrectly recycled inhalers (first published Winter 2018) 2018 saw ‘Complete the Cycle’ (a GSK-funded inhaler recovery and recycling scheme) being offered at both local hospital and community pharmacies in Cwm Taf University Health Board area – making it easier for patients to drop off their used inhalers to help reduce plastic waste and protect the environment. Both Complete the Cycle and the Health Board’s ‘Your Medicine, Your Health’ campaign give patients the opportunity to seek advice from their pharmacist on how to take control of their own health. This can be through Amy Matthews and Gareth Hughes at Sheppards Pharmacy – part of the Complete learning good inhaler technique or the Cycle project participating in a medicine’s review to get the most out of their medicine. Research commissioned for GSK greenhouse gases will be safely a unique opportunity for patient revealed that 33%[i] of patients collected and reused, for example interventions, ensuring that they nationally use their kerbside recycling in car air conditioners. The plastic are making the most of their service to dispose of their asthma and aluminium parts of inhalers medicines. inhaler, wrongly thinking that the are also recycled and used to make “We will definitely be looking to inhaler will be recycled. non-medical products such as roll out the scheme across more Many respiratory inhalers contain garden furniture.” of our 33 branches.” plastics and gases that are not The Complete the Cycle scheme has Amy Matthews, Pre-registration readily recycled through existing so far potentially saved the amount of Pharmacist at Sheppards Pharmacy arrangements, so are typically carbon dioxide emissions equivalent (pictured), said: “Identifying incinerated or end up in landfill. to taking 5,199 cars off UK roads.[iii] The inhaler aerosol canister can patients that may be over-using or then leak harmful greenhouse gases Emma Williams, Community under-using their inhaler therapy, into the air. The House of Commons Pharmacist Lead for the health which could be due to poor inhaler Environmental Audit Committee board said: “It’s really important technique, can lead to important has also published a report into to regularly check the medicines consultations to improve the the UK’s progress on reducing you have at home and return any management of their condition and F-gas emissions – these are the medicines that you no longer need enhance patient care, all within greenhouse gases which have a high or have gone out of date to our a pharmacy setting and without global warming potential. It said that local pharmacy for safe disposal. needing to make an appointment.” inhalers contribute to 3.5% of the Returning used and unused inhalers NHS’ greenhouse gas emissions.[ii] to the pharmacy will mean that Emma Williams continued: “Aligning the two schemes is a The Committee called for more these can be recycled, helping the people to use a pharmacy-based environment and giving you the great example of how patient inhaler recycling scheme. chance to speak to the pharmacist safety and environmental who can help with questions you sustainability can help drive quality Robyn Miles, GSK’s Head of improvements in our own health may have about your medicines.” External Affairs in Wales said: and make economic sense.” “By taking all types of inhalers to Gareth Hughes, Professional a participating hospital pharmacy Services Manager, Sheppards such as Ysbyty Cwm Rhondda, or Pharmacy, Rhydyfelin (pictured) said: to a local participating community “This scheme allows the pharmacy pharmacy, the aerosol canister to play a role in protecting our For more information, visit: will be separated from the plastic environment by encouraging inhaler www.completethecycle.eu components of an inhaler and any recycling, whilst also providing www.cwmtaf.wales

[i] GSK data on file, August 2017, ref: UK/OTH/0025/17 [ii] UK Progress on reducing F-gas emissions (UK Parliament). 18 April 2018. Available at: https://publications.parliament.uk/pa/cm201719/ cmselect/cmenvaud/469/46902.htm. Accessed 25 April 2018 [iii] GSK data on file, February 2018, ref UK/RET/0010/18

Page six ABPI Cymru Wales Bulletin WINTER 2019 Edition 23 A new era of partnership to deliver the best for patients (first published Winter 2018) The joint working agreement between Pfizer and Swansea University is focused on supporting the development of a system that better aligns industry, the NHS and academia in the pursuit of improved patient and public outcomes. The agreement, which aligns with the efficiency, but a fundamental wellbeing for the region’s population Wales Government National Strategy, shift towards greater partnership of over one million people. sees Pfizer and Swansea University between the health service and other Erik Nordkamp concluded: working in partnership to drive forward stakeholders, including industry.” “Our strategic partnership with ambitious local health, wealth and Swansea University and the wellbeing agendas. Representing an Professor Hamish Laing, recently opportunity it represents for present optimal environment for life sciences appointed Professor of Enhanced and ongoing collaboration between research and development, the South Innovation, Engagement and industry, the Government and West Wales region has been selected, Outcomes at Swansea University, given its potential to be at the forefront commented: “Through partnerships the health system, is part of our of excellence in healthcare service with industry we will design new ongoing commitment to enhancing delivery, research, education and approaches that focus on the value long-term health and social care. innovation. The alignment between medicines and interventions deliver We’re incredibly excited about the the Welsh NHS, academia and industry for patients and healthcare systems, future of these partnerships and in South West Wales has created using real-world outcomes that the opportunities they represent. the right environment that provides matter to inform a new sustainable We’re thinking big and look forward the potential for these ambitious paradigm that meets the needs of to ongoing collaboration between collaborative plans to discover, develop citizens and payers for the future.” industry, Government and the and improve healthcare delivery. NHS to improve UK health and The foundation to the partnership put patients first.” Erik Nordkamp, Managing Director, focuses on real-world research and Pfizer UK, describes the backdrop innovative projects in the health and For more information visit to the Pfizer and Swansea University life science sector, as well as support www.pfizer.co.uk/joint-working- joint working agreement: “Demands of the proposed Llanelli Wellness project-between-swansea- from an ageing population and and Life Science Village. The central university-and-pfizer-ltd continued medical advances purpose of this work is to deliver require not only investment and the improved vision of health and PP-PFE-GBR-1530 – November 2018

Promoting Hepatitis C Awareness in the Welsh Assembly (first published Summer 2018) Raising awareness about the Among the political visitors to the peer-to-peer services they offer and to risk factors of Hepatitis C and exhibit was Vaughan Gething AM, find out more from the clinicians about encouraging those at high risk Cabinet Secretary for Health and the ease of testing in local communities. to get tested should form the Social Services (pictured). The meeting coincided with the launch basis of a strategy to eliminate He acknowledged the importance of of an online animation which was the virus as a public health raising public awareness of Hepatitis promoted via the Welsh media and on C as a means to help identify the 50% social media platforms. concern in Wales. of people who are undiagnosed, and To get this message across to AMs also as a means to reduce the stigma ◗ You can watch the video at: in the National Assembly, AbbVie that still exists with the condition. Mr www.youtube.com/ hosted an exhibit in the , Gething was particularly interested to watch?v=b7v4-43hBo0 sponsored by Dawn Bowden AM, speak to the Hepatitis C Trust about the where AMs were invited to play an interactive game to learn more about the risk factors for Hepatitis C, from tattooing and piercing to the use of unsterilised surgical equipment. Alongside AbbVie’s exhibit, local clinical specialists and the Hepatitis C Trust were on hand to talk to politicians about the innovative work they are leading across Wales to support patient access to testing and Cabinet Secretary for Health and Social Services, Vaughan Gething AM, visits treatment in local communities. Assembly exhibit on Hepatitis C

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Tales from the Archive – Articles taken from the ABPI Cymru Wales Conferences on Collaboration held in 2015 & 2016

Cwm Taf COPD Project ¬ a joint working collaboration between GSK and Cwm Taf University Health Board (first published Autumn 2015) A joint working Chronic Obstructive Pulmonary Disease (COPD) project between Cwm Taf University Health Board (CTUHB) and GSK Ltd, where both organisations pool skills, experience and resources with an equal commitment to the successful delivery of patient- centred outcomes. This project Claire Davies from Leo Pharma outlining work undertaken with the South West Wales focused on four key areas: Cancer Centre  An educational programme for Healthcare Professionals (HCPs) Working Together to Raise Awareness around  An audit tool offered to participating practices across Cancer Associated Thrombosis (South CTUHB for COPD West Wales Cancer Centre, Abertawe Bro  A lead COPD GP and/or practice nurse from each participating Morgannwg University Health Board (ABMU practice, who currently run a COPD clinic in their respective HB) and LEO Pharma) (first published Summer 2016) practices were responsible for reviewing their COPD population This project was instigated by the South West based on NICE COPD Guideline Wales Cancer Centre, ABMU HB, due to a lack of 2010 standards of care  Smoking cessation support awareness of Cancer Associated Thrombosis (CAT) offered during all HCP among patients and healthcare professionals. interactions with COPD patients that were current smokers. There was no single patient pathway The aim was to understand for CAT patients, which resulted in opportunities for providing an This project aimed to assess an increased demand on DVT clinics. improved service within the existing whether improvements in HCPs’ Members of the oncology nurse group resource capabilities that would knowledge and confidence of were not being used in the venous increase CAT awareness among COPD and smoking cessation thromboembolism (VTE) management patients and bring patient issues to service provision would result in of cancer patients and there was an the forefront by looking at the service enhanced patients’ understanding absence of specialised CAT guidance. from the patient perspective. of their condition. NB: GSK were not directly involved in patient review and had no access  What is a venous thromboembolism? to patient identifiable data. Venous thromboembolism (VTE) is the formation of blood clots in the vein. When a clot forms in a deep vein, usually in the leg, it is called a deep vein thrombosis or DVT. If that clot breaks loose and Chrissie Bryant (GSK) outlines the travels to the lungs, it is called a work being undertaken with CTUHB pulmonary embolism or PE. to improve patient outcomes in COPD

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Clinical Inertia or Prudent Care? (first published Autumn 2016) University of Swansea, Janssen-Cilag Ltd and Bevan Commission working in partnership

Diabetes is the fastest-growing In Wales, researchers found that health threat of our times and What is the long delays between high HbA1c an urgent public health issue. levels and increases in medication to address poor disease control Diabetes UK recently reported that SAIL Databank? occurred, despite existing evidence in the last 20 years, the number strongly linking high HbA1c levels with of people living with diabetes in The SAIL Databank at Swansea complications. Researchers working Wales has more than doubled, to University holds multiple health on previous studies linked to diabetes over 180,000, with a further 70,000 datasets, which cover the entire have concluded that there is a direct people estimated to have Type 2 relationship between glycaemic diabetes without realising it. Welsh population. Billions of control and complications, and “even As part of ongoing research, a recent anonymised records, linked by a modest reduction in glycaemia has joint-working initiative involving the patient identifiers, relating to the potential to prevent deaths from complications related to diabetes”.1 University of Swansea, Janssen- about 5 million individuals, are Cilag Ltd and the Bevan Commission ‘Tight’ control of HbA1c may be investigated the relationship between available and currently used inappropriate or unrealistic for some, poor glycaemic control (HbA1c) in research. At the time of this due to factors like age, frailty and and treatment intensification in research, primary care data for patient preferences and there may be primary care across Wales. This opportunities to instigate other methods research was undertaken in the light 55% of the Welsh population of control, such as lifestyle interventions. of NICE treatment guidance, using were available and served as the However, given current evidence, routinely collected data in the Secure main data source for analysis. the findings suggest an opportunity Anonymised Information Linkage to improve outcomes in Wales by (SAIL) Databank. providing more timely treatment.

1. Stratton, I.M., Adler, A.I., Neil, H.A., Matthews, D.R., Manley, S.E., Cull, C.A. et al. ‘Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.’ BMJ, 2000 Aug 12;321(7258):405-12. PubMed PMID: 10938048.

Who we are The Association of the British Pharmaceutical medicines pipeline, ensuring that the UK remains at the Industry (ABPI) represents innovative research-based forefront of helping patients prevent and overcome diseases.​ biopharmaceutical companies, large, medium and small, Globally our industry is researching and developing more leading an exciting new era of biosciences in the UK. than 7,000 new medicines. Our industry, a major contributor to the economy of the UK, brings life-saving and life-enhancing medicines to patients. The ABPI is recognised by government as the industry We represent companies who supply more than 80 per body negotiating on behalf of the branded pharmaceutical cent of all branded medicines used by the NHS and who industry for statutory consultation requirements including are researching and developing the majority of the current the pricing scheme for medicines in the UK.

For further information about any of the issues in this Bulletin or about ABPI Cymru Wales, please contact:

Dr Richard Greville, Director ABPI Cymru Wales Email: [email protected] Tel: 029 2045 4297

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