Brexit, Health Policy and Pharmaceuticals

Burson-Marsteller, a leading public affairs consultancy, recently held a conference in Brussels on the topic of ‘Brexit? The impact on Health Policy and Pharmaceuticals’ .

Over 50 people attended, drawn from a full range of interested organisations, industry and the EU institutions. 

The overwhelming opinion-- from all quarters-- was that if the UK left the EU there would be a large damaging impact on not only the UK's life sciences industry but the wider healthcare system and regulatory framework of Europe as a whole. Not only are UK firms leading in this sector but UK policies and healthcare thinking are driving much of the EU's agenda. All this would be put at risk if the UK left. 

Some of the more significant impacts included:

1. Leaving the EMA and mucking up authorisation of medicines

The European Medicines Agency (EMA) is the hub of EU pharmaceuticals regulation – and it is based in London.
Were the UK to leave the EU’s medicines regulation structure completely, there would clearly be a question mark over whether centralised marketing authorisations would still apply in a post-Brexit UK.
For the rest of the EU, the question mark would hang over ongoing market authorisations. What would happen to marketing authorisations during the Brexit process – and would we see a period of delay in which new authorisations are put on hold?

2. Creating confusion and duplication outside

The UK would face a huge administrative undertaking to establish a separate regulatory system for pharmaceutical safety, and it is far more likely that the UK would stay close to the EU on such matters.
Switzerland presents an interesting case, however: it has a world-class pharmaceutical industry, but is outside of the EU/EEA and most regulatory cooperation. Is this success based on the financial incentives of being based in Switzerland? Would the UK have to go down a similar road to attract investment?
The Swiss recently suffered a cut to EU R&D funding (under the Horizon 2020 programme) when it voted to end free movement of people from the EU. EEA membership would probably require adherence to the EU’s free movement principles – something that may be unpalatable given that migration is likely to be a key motivating factor for pro-Brexit voters.
A Swiss-style Horizon 2020 funding cut could see a flight of academics from the UK to countries that would have easier access to collaborative international research projects.

3. Abandoning the  EU health agenda
EU public health policy may be weakened by UK exit.
The UK drives many policies aimed at improving health (even though these policies are often frustrated by internal market rules): reform of the common agricultural policy, with subsidies for healthier foods, and not sugar or tobacco; traffic-light food labelling; minimum unit pricing for alcohol, notably in Scotland.
Likewise, on plain-packing for cigarettes, the UK wishes to go further than the rest of the EU. Will a Britain-less EU miss the UK’s progressive health policy stance?

4. Making the UK a harder market to invest in 
The UK business environment for pharmaceuticals has a fine balance of pros and cons. The UK is a large market with a competitive corporate tax rate and good universities. The government has a clear commitment to life sciences, with a dedicated minister and government strategy for the sector.
But the National Health Service is slow to adopt innovation. Late stage clinical trials are difficult to conduct in the NHS, and pricing and reimbursement negotiations can be tough.
An EU exit could tip the scale against investment in the UK: certainty of trade conditions is a vital factor in determining investment decisions.

5. Can the pharma industry support a ‘Yes’ campaign?
Given the sensitivity of the topic and the mixed reputation of Big Pharma, it is hard to see drugs companies backing a ‘Yes’ campaign any time soon.
Some CEOs may wish to support David Cameron’s game, and hang back from supporting membership until the Prime Minister presents his proposals for ‘renegotiation’ – effectively endorsing Cameron’s approach of supporting membership, but not at all costs. The industry may also be weighing whether more competitive advantages might be sought by taking a tough stance.
Nevertheless, many fear Brexit and want to do something sooner, helping to shape the debate.

A key role for campaigners for Yes will be to encourage the pharma industry and its leaders to engage in the conversation and stress the positive stories of the UK's success and opportunity here-- all of which will be put at risk if the UK leaves. Silence is no longer an option.

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