We can change the way we develop and fund drugs

So someone got up a petition and we all signed it. Essentially - and I think this is quite clever - the petition asked the local council to let us pay £100 each a year to park outside our houses, or at least near enough to our houses to not require a taxi home. How clever is that? We were asking for permission to give them money. They toyed with us awhile and said that there had been so many similar requests for parking permit schemes we would have to wait a few months. I think they might have been trying to get us to increase our offer. But eventually they gave in and took our money.

It is a brilliant business model. Getting your target audience to fight for the right to give you money and to be grateful for the opportunity to do so - indeed, to be willing to pay you extra when you put the price up the following year. I wondered why nobody had thought of anything like that before, and then I thought of the health service and NICE and the drug companies.

‘I can’t help fantasising about a scenario in which drug companies work as part of the NHS, developing products and innovating directly to benefit patients’

NICE has a hard job, working out what is affordable and what is reasonable in an ever-changing clinical environment. It is presented regularly with new, life-extending drugs and it has the difficult task of recommending whether or not these drugs should be made available to the NHS. However, it doesn’t get to negotiate prices or barter on behalf of patients or services. Instead, health services have to pay what they are told and be grateful for the opportunity to do so.

It is brilliant business for drug companies anxious to gather rewards for their innovation and shareholders, and confident that they have the health service over the proverbial barrel. And, of course, politicians of all persuasion will tell you that this is why the internal market works - profit drives innovation. But only because nothing else has been tried.

I can’t help fantasising about a scenario in which drug companies work as part of the NHS, undertaking research, developing products and innovating directly to benefit patients and without the need for share prices and profit. It would save billions.

The people doing the research and development could still be well rewarded and the health service could work toward a single purpose - patients.

Naïve and unthinkable? Probably. Unfashionable? Certainly. And, no doubt, impossible. Who would have the political courage to entertain such silliness? But is it really beyond us to think of organising the way we provide health care and develop and fund the drugs that dominate it to focus on well-being and effectiveness, rather than the financial opportunities they offer?

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