Innovation on hold – why NICE medicines struggle to reach patients

Despite bold ambitions in the Life Sciences Vision and NHS 10-Year Plan, uptake of new medicines remains slow. Can industry, government and providers finally bridge the gap between approval and access?

The UK stands at a crossroads in medicines policy. The government continues to champion life sciences as a central pillar of its industrial strategy, with the Life Sciences Vision and NHS 10-Year Plan both emphasising the UK’s potential as a global leader in innovation, research and patient-centred care.

Yet for industry, the reality is more complex. The breakdown of negotiations around the Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) reflects this tension: companies are urged to invest in UK R&D and trials while facing financial constraints that threaten commercial viability and patient access.

This contradiction has consequences. Once the fourth most attractive global launch market, the UK has slipped closer to tenth, making it harder to justify prioritising new therapies here beyond R&D, real-world evidence and selective NHS partnerships.

And yet, there is still promise. The Life Sciences Vision sets out ambitions to enable world-class R&D, make the UK a leading place to grow and scale businesses and accelerate health innovation alongside NHS reform.

Crucially, it acknowledges the persistent problem of slow uptake of NICE-approved medicines while signalling intent to tackle it through commitments to biosimilars, a single national formulary and adjustments to NICE’s cost-effectiveness framework.

These steps highlight both the complexity of the challenge and the opportunity if the UK can get this right.

The slow uptake of NICE-approved medicines is well known. Local variation in commissioning, fragmented funding pathways and formulary delays create a postcode lottery in access. Competing clinical priorities and limited resources often mean that even when approval is secured, embedding new treatments takes far too long.

Financial pressure compounds the problem. Commissioners must deliver short-term savings, making it harder to adopt innovations that bring upfront costs but promise longer-term efficiencies. Workforce strain also limits the system’s ability to adapt care pathways or deliver training needed for new therapies.

Yet despite these challenges, reasons for optimism remain. The NHS is home to a resilient and committed workforce – clinicians, researchers and managers remain eager to innovate. When collaboration works, uptake can happen at pace.

The COVID-19 vaccine rollout proved that the UK can deliver innovation rapidly when incentives and infrastructure align.

Similarly, the Early Access to Medicines Scheme (EAMS) has enabled patients with multiple sclerosis to benefit from disease-modifying therapies sooner, while the Innovative Medicines Fund is widening access to targeted cancer drugs such as therapies for lung and breast cancer.

The Accelerated Access Collaborative (AAC) has supported the uptake of biologics in severe asthma through coordinated pathway redesign, and the NHS-industry partnership on hepatitis C elimination has delivered one of the fastest infection declines in Europe.

These examples show that clear mechanisms and aligned priorities can overcome structural barriers. The government’s 10-Year Plan reinforces this potential, linking life sciences growth with NHS reform and an ambition to make the UK an ‘outstanding place to grow, scale and invest.’ The appetite is there – if adoption can be made sustainable.

Providers sit at the centre of the uptake challenge. They balance local priorities, budgets and patient outcomes and are the ones tasked with embedding new medicines into pathways. Two groups are especially important: hospitals and neighbourhood teams.

At the hospital level, providers manage large patient cohorts and specialised services, often leading in the trial and adoption of breakthrough therapies.

Hospitals can shape system-wide change when innovations align with strategic priorities such as reducing length of stay, tackling backlogs or improving survival rates. Early diagnostic technologies in oncology are a clear example, reshaping pathways in hospitals before extending into community care.

Meanwhile, neighbourhood teams – working closer to patients – offer a different type of opportunity. With more flexibility and less central scrutiny, they can test innovative approaches at scale.

They have already demonstrated impact: rolling out continuous glucose monitoring in diabetes to prevent complications or using digital adherence tools in respiratory care to cut hospital admissions. These successes show the value of deploying innovation where it directly supports patients’ daily lives.

The message for industry is clear: know your audience. Too often, engagement is generic and misses the nuances of hospitals, ICSs or neighbourhood teams. Real progress comes when partnerships are tailored to specific needs – whether that’s backlog reduction in hospitals or chronic disease management in communities.

This shift requires moving beyond transactional approaches to true partnership. It may mean supporting staff training, co-developing data collection or embedding digital solutions. It also requires patience. Trust is built over time, and providers are more likely to work with companies that demonstrate consistency, understanding and commitment.

With the UK increasingly compared unfavourably to European peers on uptake, building these provider-level relationships is not just desirable but essential. Hospitals bring influence and reach, neighbourhood teams bring flexibility and scale – and together, they hold the key to embedding innovation.

Policy reform will shape the long term, but industry can act now to strengthen its role as a trusted NHS partner and accelerate uptake. Five priorities stand out:
While policy reforms and national negotiations such as VPAG will shape the longer-term landscape, there are immediate steps the life sciences sector can take to strengthen its role as a trusted partner to the NHS and improve uptake of innovation.

1. Partner with ICBs on education and quality standards
   Rather than delivering standalone programmes, companies should work directly with Integrated Care Boards (ICBs) to co-design education that aligns with local population priorities and NICE quality standards. For example, a collaborative programme on heart failure could support GPs, pharmacists and hospital specialists in meeting national standards while addressing local gaps in care
2. Tailor engagement to provider needs, not generic offers
   Hospitals and neighbourhood teams face very different challenges. Industry must avoid one-size-fits-all approaches and instead listen first, design second. A hospital oncology team might need pathway redesign to accommodate new diagnostic technologies, while a neighbourhood team may prioritise digital self-management tools for chronic conditions
3. Invest in real-world data partnerships
   The UK is uniquely placed to generate high-quality real-world evidence. Companies should collaborate with NHS providers to gather outcomes data that informs service design and supports uptake. Recent collaborations in inflammatory bowel disease, where registries have helped demonstrate the value of biologics in practice, show the impact of this approach
4. Build long-term relationships, not short-term transactions
   Trust is earned over time. Providers are far more willing to collaborate with companies who demonstrate consistency, reliability and commitment. This could mean supporting staff training year after year or continuing to fund joint data projects beyond a product’s initial launch period
5. Contribute to system innovation beyond medicines
   Life sciences companies can co-invest in digital solutions, workforce training and pathway redesigns that help the NHS deliver reform. For instance, co-developing digital asthma management platforms not only supports medicine uptake but also tackles system challenges like reducing A&E admissions.

The UK’s ambition to be a global life sciences leader is clear. But ambition must be matched by access.

The NHS workforce is eager to innovate, and there are examples proving that successful uptake is possible. For industry, the challenge is to move beyond generic offers, forge meaningful partnerships across hospitals and neighbourhood teams and align with local priorities.

If this happens, the UK can shift from being a difficult launch market to once again being a world-leading destination for innovation – delivering value for industry, the NHS and most importantly, for patients.