Insider Interview

Doina Ionescu: To me, the optimisation of people’s individual treatment needs must be a priority, not a luxury. More personalised approaches to healthcare today are vital to achieve the best and most sustainable health management in the future. According to recent data, supported self-management can result in 19% fewer GP appointments and 38% fewer A&E attendances. There are clearly financial implications that are positive for the NHS budget. But it’s not only about cost savings – it’s also about enabling people to live better and healthier lives.

The NHS Long-Term Plan outlines the aim that 2.5 million people are receiving personalised healthcare by 2024.

They concluded that personalised healthcare is critical in helping to reduce health inequalities, and support the future sustainability of our healthcare system.

COVID-19 put a break on personalised healthcare, but it has also accelerated the need for it, as prevention and proactive management of patients (and longer-term cost savings) will be more important post-COVID-19 than pre-COVID-19. While there is mounting evidence of the positive impact of personalised healthcare initiatives (particularly in mental health and learning disabilities) in primary care, personalised healthcare has not yet become systematically embedded in secondary care.

That’s why, at Merck, we want to focus on that issue, as well as the wider needs around personalised medicine and better/equitable genomic testing across the UK, so that newer, more targeted medicines reach the right patients.

We have created a personalised healthcare framework of accountability, supported by a set of guiding principles that will be embedded within our businesses, and all future personalised healthcare activity we initiate, or support will be evaluated against them. The framework and the principles were based on insights collected from a multistakeholder survey, which was completed by over 100 individuals working within the NHS, pharma, patient organisations, and academia. We then took a deep dive into the survey findings with multidisciplinary experts, and explored how Merck could support the implementation of the personalised healthcare agenda, with a particular focus on shared decision making and supported selfmanagement.

If we take multiple sclerosis (MS) as an example, we know that patient outcomes are better when patients have a key role to play in their ongoing treatment, and we believe this supports the NHS Recovery Plan post-COVID-19. And yet, depending on where patients live, their ability to be a part of their healthcare decisions will vary. MS patient numbers are only increasing, and services are already stretched. New models of care are needed. We want to support clinicians to make shared decision-making and supported self-management an embedded part of MS patient care, and we are working on some exciting plans to offer practical solutions and ideas for the sustainability of quality care for patients in supported self-management.

Merck also has a long-standing heritage in fertility, and we are about to launch a campaign to empower patients to become more informed, empowered, and play a more vocal role in their fertility treatment and care.

What I found striking at the outset was that there seemed to be no clarity on which organisation would be accountable for ensuring that there is a systematic approach to planning and delivering services, particularly in secondary care. We shared our Framework and Guiding Principles with NHS leaders, and the response was really positive. There is an appreciation that pharma has a key role to play. Pharma has skills and capabilities such as R&D and access to big data, which can help to enhance health and close the gap in health inequalities. I think that we need a task force – just like the Vaccine Task Force – that has one consistent goal and that brings people together from industry, Integrated Care Systems (ICS), the NHS and patient organisations. Merck hopes to be able to play a pivotal role in driving additional initiatives forward in partnership with the NHS. The NHS can’t do it all by itself.