joint working slides for the website april 2009

8/13/2019 Joint Working Slides for the Website April 2009

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Joint Working with the NHS

Joint Working between Pharmaceutical Companies andthe NHS and Others for the Benefit of Patients

An introduction to the ABPI guidance notes


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www.abpi.org.uk

Content

This presentation is a brief summary of key issues in

the ABPI Guidance Notes on Joint Working.

Joint Working between the NHS and the pharmaceutical

industry is a relatively new concept and companies are

likely to have little or no historic experience. The

purpose of the ABPI Guidance is to support appropriate

Joint Working including how potential pitfalls might beidentified and avoided.


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Quick Guide to the Guidance Notes

Chapter Key content

Purpose of this Guidance Outlines the need for a framework for joint

working.

Background to Joint Working Describes how NHS and pharmaceuticalcompany relationships are evolving.

Definition and Scope of Joint Working Patient benefit and pooled resources are core.

Describes what is not Joint Working.

Principles of Joint Working Need for patient benefit, mutual benefit,

transparency and organisational level sign off.

Examples of Joint Working Suggested types of activity that can be included

in Joint Working projects.

Joint Working Governance Transparency and the need to avoid

inappropriate influencing of prescribers.


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Chapter Key content

The Mutual Benefits of Joint Working Describing patient, NHS and company

benefits. Being clear about expected outcomes.

Measuring Joint Working Affirms that measurement is required and

suggests criteria that can be assessed.

Deciding to Take Part in Joint Working Being transparent, how to calculate return on

investment for all and the importance of patient

benefit.

Joint Working Agreements Need for a formal agreement and specific areas

that should be included.

Disengagement/Exit Criteria Need to define a clear end point at the outset.

Reasons to exit an agreement early.


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Chapter Key content

Joint Working Projects and Clinical No inappropriate influencing of

Guidelines prescribers. Supported guidelines must be

independent.

Communicating Joint Working Projects Consistency of message. Ensuring JW is not

within the Company used as inducement by representatives.

Using Data Obtained from Joint Working Outlines the various legislation that applies.

Projects

Competition and Commercial-In-Conference Applies when more than one company is

Issues involved. Legal counsel may be required.

Other Considerations Personal benefit must not come from joint

working. Anti corruption rules.


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Other relevant documents

Moving beyond sponsorship: Interactive toolkit for joint workingbetween the NHS and the pharmaceutical industry, Department ofHealth/ABPI (March 2008)

Best practice guidance for joint working between the NHS and thepharmaceutical industry, Department of Health (February 2008)

A Common Understanding: Guidance on Joint Working betweenNHS Scotland and the Pharmaceutical Industry (2003)

Guidance for Partnership Working between NHS Organisations,Primary Care Contractors, the Pharmaceutical Industry and the

Allied Commercial Sector in Wales (2004)

ABPI Code of Practice for the Pharmaceutical Industry (2008)


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ABPI Code

Most relevant clausesClause 18.

Joint working must not be an inducement to a health

professional to prescribe, supply, administer,recommend, buy or sell any medicine.

Only informal guidance about the Code can be provided

by the PMCPA.


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Whats in this presentation?

Overview of content

Definition of Joint Working

Suggested audiences

How to articulate benefits and return on investment

Summary of mutual benefits

Placing of initiatives (Targeting)

Measurement

Communication to sales forces and others

Key differences between medical and educationalgoods and services and joint working

Potential pitfalls


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Suggested Audiences

This presentation is for those most likely to have a keyrole in the development and implementation of jointworking projects such as:

Medical signatories NHS liaison team management

NHS liaison teams

Brand marketing teams

Compliance officers Legal


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The key requirements from this

definition are that:

the Joint Working project must be focused on benefits

to patients; and

there must be a pooling of resources between thepharmaceutical company/ies and the NHS

organisation(s) involved.



Each party must, therefore, make a significant

contribution to the Joint Working project to avoid the

arrangement being construed as merely a gift, benefit in

kind, donation or some other non-promotional/commercialpractice.

Resources may come in various forms, including people,

expertise, equipment, communication channels,

information technology and finance.

Key requirements continued



Joint Working must:

benefit patients (expected to also mutually benefit the

parties).

be conducted in an ethical, open and transparent manneroverall arrangements made public.

take place at a corporate organisational level and not with

individual health professionals.

be in accordance with the ABPI Code, government

guidance, NHS rules and relevant professional codes, etc.



Investment

Joint Working projects are likely to be of significant

scope and size, involving resources in the region of 15

- 20k or more and lasting six months or longer. Lower

figures may be applicable depending on circumstances.

The key determinant is whether a project follows the

principles of joint working.



Benefits of Joint Working

When describing the benefits of a specific joint working project

one must be able to:

Clearly define patient benefits

Show how the NHS will benefit Describe how the company will benefit

Ensure that both parties are comfortable with the

arrangements

As these are business to business arrangements it is both

reasonable and appropriate for both parties to consider returnon investment (ROI) before committing to any project.

Commercial benefit to either party must not be the sole benefit.




Pharmaceutical companies can calculate ROI provided

governance arrangements are in place

ROI calculations should be set out in the context of patient

care and shared with the parties The aim of conducting ROI analysis should be made clear

eg to make decisions on resource utilisation

Companies should not terminate a project solely on the

basis of a negative ROI for its medicines

Both parties, the NHS and company, should be able to articulate

their ROI in clear and measurable terms




for patients can include:

Care closer to home

Fewer hospital admissions

More equitable and consistent care and access to care

Better information about conditions and treatment options

Clearer and improved care pathways

Better experience of the healthcare system


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for the pharmaceutical company

can include:

Market expansion and/or more appropriate use of medicines,including the companys medicine(s)

Better understanding of customers and patients needs Improved reputation

Faster NHS implementation of policy which may be relevant to thecompanys business


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Measurement

The outcome of every project should be measured and

baseline measurements might be helpful to track

success, particularly patient outcomes.



Exit Criteria

Must be agreed and included in the Joint Working

agreement.

Either party should be able to exit an agreement ifpatients are not benefiting and must do so if the project

is detrimental to patients.

A pharmaceutical company may not terminate a Joint

Working project solely on the grounds that prospectiveROI is not met.


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Joint Working Agreements must

include

Name, parties, date and term.

Expected benefits for patients, the NHS and

pharmaceutical company.Outline of the financial arrangements.

Roles of the parties, how success will be measured.

Contingency arrangements.Summary of Joint Working agreements to be made

public by the pharmaceutical company.


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Communication within the

company

Companies should consider how sales

representatives and other personnel are briefed to

ensure that the Joint Working agreement is not

infringed and that the project is not usedinappropriately by sales representatives to gain

access to customers or to influence prescribing

The importance of consistent communication within a

company regarding Joint Working initiatives shouldnot be underestimated


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Potential pitfalls

Joint Working is different to the provision of Medical

and Educational Goods and Services (MEGS) that

enhance patient care or benefit the NHS and

maintain patient care.

It is very unlikely that the provision of MEGS would

ever meet the definition of Joint Working as they are

mainly provided by a pharmaceutical company in

circumstances where there is no pooling ofresources.


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Key Differences between Medical and

Educational Goods and Services and

Joint WorkingMEGS JW

NHS/Pharma company pool resources x P

Detailed JW agreement xP

Outcomes must be measured O P

Shared commitment to successful delivery P P

Details of arrangement made public O P

O = Optional


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Is a proposal for Joint Working

in line with ABPI guidance?

Chapter Features of proposal

Definition and Scope Able to describe how patients, the NHS and of

Joint Working the company are likely to benefit. There is a clear

and significant pooling of resources between the

company and the NHS. Certainty that this is not just atraditional MEGS activity.

Principles of Joint Working Patients are the principal beneficiary. A written

agreement will be in place.

Joint Working Governance The project is transparent. Have ensured that

the project has been agreed at an organisational

level so that inappropriate influencing of

prescribers has not occurred.


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Is the proposal for Joint Working

in line with ABPI guidance?

Chapter Features of proposal

Measuring Joint Working Have a range of measures that are specific to the

patient, NHS and company. Have expected

outcomes for this project and an agreed schedule for

measurement to ensure these take place.

Deciding to Take Part in Have considered a balance of benefits for all parties and can

Joint Working clearly show that decisions have been made at an

appropriate level in the company. Any ROI

calculations have been made to support resource

allocation decisions.

Joint Working Agreements Have a formal agreement in place that is very clear

about what all parties have agreed. Have not started the

project prior to having this agreement.


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Further advice

ABPI - Martin Anderson (Director, NHS Policy and

Partnerships) on 020 7747 1401 or

[email protected]

ABPI Extranet

PMCPAHeather Simmonds, Director on 020 7747

1438 or [email protected]

joint working slides for the website april 2009

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