Game of life

Combination treatments combine two or more individual medicines or types of therapy to treat a disease. They have the potential to deliver significant clinical benefits to patients.

However, many have been held back from public access over recent years due to cost-effectiveness concerns.

In 2024, the Voluntary Scheme for Branded Medicines Pricing Access and Growth (VPAG) committed to increased commercial flexibility including two consultations on updates to the NHS Commercial framework for new medicines.

This is a critical step towards recognising the access issues to these potentially life-extending combination treatments.

The first phase of the consultation has brought promising developments, with the framework now confirming National Health Service England (NHSE) and National Institute for Health and Care Excellence’s (NICE) support for the Competition and Markets Authority’s (CMA) position statement and inclusion of publicly available data on the number of active commercial access arrangements.

These are valuable steps towards open and more transparent collaboration, which will improve combination treatment access.

However, there are still gaps that need to be addressed.

NHSE, NICE and industry need to continue working together to implement the CMA framework.

We will also need to apply the flexibilities that NHSE is seeking to enable the updated commercial framework to find a complete solution for combination therapies.

Although these conversations are promising and show that the needle is moving on understanding and supporting the ability for patients to access these treatments, access continues to remain a challenge.

Combined effort

At Takeda, in my role as head of Oncology for UK and Ireland, I can see the potential for life-extending treatments for cancer patients across the UK when combination treatments are accessible.

I hope we can make an impact towards improving this access with the ‘Conceptual Implementation Framework: Making Solutions Transactable for Combination Treatments in a Not Cost-Effective at Zero Price Scenario’.

We know from experience in complex diseases, such as cancer, HIV, rheumatoid arthritis and hepatitis C, that combination treatments can provide significant clinical advantages to patients.

This is because using multiple treatments in combination can simultaneously target numerous pathways that drive a disease.

• In cancer, there is broad consensus that combining different treatments may improve the efficacy of using a single treatment on its own
• In HIV, a combination of antiretroviral medicines is used because the virus can quickly adapt and become resistant to treatments
• In hepatitis C, using a combination of treatments that work in different ways can be more effective and prevent the development of disease resistance.

More must be done to implement workable solutions so patients can benefit from effective combination treatments.

This drive aligns with the Government’s ambition to grow the life sciences sector and transform the NHS into a service that delivers world-class patient outcomes, as it will allow companies to bring more innovative medicines and investment to the UK.

By addressing these challenges, we can not only enhance patient care but also stimulate innovation and growth within the life sciences industry.

Looking at the most recent moves towards improving combination treatment access, we still see areas have not been addressed where future issues may arise, slowing down the progress.

Published in February 2025, Takeda’s Conceptual Implementation Framework: ‘Making Solutions Transactable for Combination Treatments in a Not Cost-Effective at Zero Price Scenario’, sets out to address these gaps.

The Conceptual Implementation Framework has been developed in consultation with industry experts, ensuring that suggested solutions are workable and relevant to those on the front lines in improving access.

We have sought feedback from a wide range of stakeholders, including clinical, patient and access communities, resulting in a framework that provides actionable solutions to real issues in the sector.

In terms of next steps, collaboration is paramount. The cost-effectiveness issues for combination treatments must be recognised as an ongoing challenge and remain a priority.

Communication must lie alongside collaboration, with open, honest and clear conversations about the availability of solutions.

Stakeholders must have a willingness to adopt and trial proposed solutions.

Finally, as with anything, there must be systems in place to support regular evaluation, review and feedback.

We have made great strides with combination treatments and, by working together, we have created a roadmap of how different groups can make a positive impact in the future.

The framework takes a whole-system view of implementing solutions for cost-effectiveness issues with combination treatments.

It outlines opportunities, policy levers and points across the combination treatment regulatory and access continuum where potential cost-effectiveness issues could be identified.

By using the framework as a guide and continuing the conversation, we can continue to make progress on unlocking patient access to life-changing medications.

On 25th March 2025, we will be hosting a webinar with thought leaders and industry experts to act as a forum for these discussions.

It will be an opportunity to engage with policymakers, patient groups, clinicians, media and industry leaders on solutions and collaboration opportunities as we dive deeper into how we can make more combination treatments accessible, even in cost-challenging scenarios.

Dr Emma Roffe, Oncology Country Head, Takeda UK & Ireland.
Go to Takeda.com/en-gb