Pharmaceutical Research and Development Spending

Lord Patel Excerpts

Thursday 13th October 2022 Grand Committee

[Lord Patel (CB)]

My Lords, I might end up repeating some things that have already been said, but that will just reinforce the important aspects of this debate. I thank the noble Lord, Lord Hunt, for initiating it, and the noble Baroness, Lady Wheeler, for introducing it.

I was going to try to focus on two things. One was clinical trials and the other was potential research into dementia. We know that clinical trials are an important part of domestic R&D, an important source of revenue for the NHS and a critical way of delivering early access to promising treatments for patients. As has already been mentioned, in the 2018-19 financial year, in addition to the revenue generated, there were £30 million of pharmaceutical product cost savings from trials supported by the NIHR clinical trials network. Numerous studies have also shown that research-active NHS facilities deliver better patient outcomes.

It has already been said that the UK has slipped down the global rankings and our reputation as a reliable destination to locate clinical trials is taking a hit. The National Institute for Health and Care Research found that there were about 28,000 participants recruited into clinical trials in 2021-22, compared with over 50,000 in 2017-18, and patients in different parts of the country, as the noble Baroness, Lady Walmsley, has already mentioned, have wildly varying experiences of being able to participate in research. The noble Baroness gave the particular example of cancer research. As she said, cancer patients in west London are 71% more likely to be asked to take part compared with those in some other areas. That is quite shocking, because cancer research trials were one area where we excelled.

The pandemic obviously had an impact on this decline. R&D leaders in the NHS estimate—again, as the noble Baroness, Lady Walmsley, mentioned—that we lost something of the order of £0.5 billion. But it cannot be ignored that the UK was beginning to decline pre Covid, and our post-pandemic recovery is lagging behind that of other countries. Even Spain has now overtaken us in the world ranking of clinical trials. We are now number 8, whereas some years ago we were number 2.

There are ways that we can tackle this, including by streamlining the slow set-up of recruitment to studies. So can I ask the Minister what the Government are doing to prioritise the recovery of industry clinical trials in the UK and ensure that research is embedded as part of routine NHS care across the whole of the UK? I think he has a golden opportunity as a new Minister to get some people into his office and demand that we change this declining position. Clinical trials should be a key part of our NHS research agenda.

I will now return to some aspects of dementia research that the noble Lord, Lord Goodlad, mentioned. It is the ambition in the life sciences vision of the Government to escalate novel treatments for dementia. As has already been mentioned, Alzheimer’s Research UK is concerned that the government commitment to research into Alzheimer’s is now slowing—to put it mildly. We know that dementia is the world’s biggest health challenge, with almost 1 million people in the United Kingdom alone suffering, and we know the heartbreak it causes not just to individuals but to their families.

Traditionally, this area has been risky for investment, but the commitment of dementia researchers over many years has led to some recent scientific breakthroughs and a growing pipeline of new treatments in clinical trials from which we in the United Kingdom are not benefiting. In recent news, a treatment called Lecanemab has shown in initial phase 3 clinical trials that it can slow down patients’ decline in memory and thinking. It is very promising. Taking these together, this means that dementia research is at a tipping point of progress. Continued life science investment is crucial to delivering the safe and effective treatments that people with dementia desperately need.

Over the past five years, we have seen an overall decline in the number of dementia trials being initiated in the UK and the number of participants in each trial. The noble Baroness, Lady Walmsley, mentioned how Germany, France and other countries have outstripped us in initiating dementia clinical trials, which is sad to have to admit. One of the reasons is that as a country we identify the problem at a later stage of the disease. We currently diagnose people with dementia too late, so their condition has progressed beyond the point where they are eligible to take part in clinical research. There is therefore a need for the NHS to address the diagnostics of dementia. Again, the point has already been made about government investment, which declined from 2018-19 to 2019-20. So the plea for the Government to have a plan to focus attention on dementia research is well made and I hope the Minister will say whether the Government have a plan to take forward research in dementia as identified in the Life Sciences Vision report of July 2021.