BresMed

Highlighting best practice as a representative in The Parliamentary Review

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from BresMed is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

www.bresmed.com

BEST PRACTICE SPONSOR 2020
9BRESMED |
BUSINESS SERVICES
CEO and founder of BresMed,
Nic Brereton
BresMed’s Sheffield
office reception
BresMed was established in 2006 and today has more
than 150 members of staff in the UK, India, Ireland,
the Netherlands and the US. It is a health economics
consultancy that works with a variety of pharmaceutical
multinationals to deliver independent outcomes research
and evidence review services. CEO Nic Brereton explains that
the technical expertise of BresMed’s team is integral to the
company’s continued success and discusses how the company
has diversified its services.
I started out working in health economics and outcomes research as a freelancer
and founded the company over 13 years ago. Our focus is on working alongside
pharmaceutical companies, supporting their applications for reimbursement to
the relevant payer agencies: the National Institute for Health and Care Excellence
– or NICE – in the case of England and Wales and the Scottish Medicines
Consortium inScotland.
Our core service is building economic models that demonstrate that the increase in
cost of a new intervention is justified by a sufficient gain in benefits to the patient
and the healthcare system as a whole. These benefits include both clinical effects,
measured as improvements in quality of life, and economic effects, which examine
the overall impact on the healthcare budget. This is an important part of gaining
approval for new drugs on the NHS, and so it is the job of health economists and
NICE decision-makers to ensure that we are maximising the overall health of the
nation when reimbursing new drugs and medical devices.
FACTS ABOUT
BRESMED
»CEO: Nic Brereton
»Established in 2006
»Based in Sheffield,
Manchester, Dublin, Utrecht,
Gurugram and Las Vegas
»Services: Health economics
consultancy
»No. of employees: 165
BresMed
THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
10 | BRESMED
Driving global growth
As the company has developed, we have
expanded our services to include the
writing of submission dossiers, statistical
analysis on clinical data and strategic
planning support. This has meant that
rather than only being involved at the
end of the drug development process,
we often get involved much earlier,
supporting clinical trial design to ensure
that the most appropriate health and
economic outcomes research – or
HEOR – data are collected to support
not just the licensing process but also
the later reimbursement case.
NICE has always been at the forefront
of health technology assessment – or
HTA – with many of the standards and
processes for evaluating the impact
of new treatments developed by NICE
and the academic institutions it has
partnered with. Within the industry,
NICE has been recognised as the
“gold standard” in HTA, which has
meant that many pharmaceutical
companies have decided to start
their reimbursement journey in the
UK – the rationale being that if their
model is robust enough for NICE, they
will be able to meet the standards
for reimbursement applications in
other countries where the process is
generally less rigorous. Our expertise
has been developed to meet the high
standards of NICE and, as a result,
we have been perfectly positioned
to provide HEOR services for other
markets around the world.
This growth has seen our team
increase from just me to over 165
employees globally, with around 100
of those in the UK. Alongside our UK
base, we also have offices in India,
Ireland and the Netherlands and have
recently set up in Las Vegas in the
US. Our global expansion, and the
establishment of these offices, has
been possible due to the success of our
UK operations.
Keeping academic rigour at
the forefront
Our key strength, and something
which has always been an integral
part of our company values, is our
academic rigour. We adopt emerging
methodology and develop our own,
all the while improving our skillsets
and retaining academic excellence
at the forefront of what we do. To
support this, we have established
rigorous recruitment standards and
have invested considerable time and
expense in their development. By
keeping methodological excellence at
our core, and establishing strong links
with key universities, such as Sheffield
and York in the UK and Colorado and
Utah in the US, we have been able to
achieve success. As we have expanded,
we have sought to build similar
academic links in other countries
around the world.
These links with universities are
essential to develop methodology
and are beneficial for both parties.
Universities are always searching for
issues within the field to research,
and we are always looking to
findsolutions.
Members of our board,
clockwise from top
left: Steve Beard, Kunal
Srivastava, Nic Brereton,
Becky Brereton, Ron
Akehurst, Sue Latimer
and Dawn Lee
Our expertise
has been
developed to
meet the high
standards of
NICE and, as a
result, we have
been perfectly
positioned to
provide HEOR
services for
other markets
around the
world
11BRESMED |
BUSINESS SERVICES
Given that everything we produce
will be publicly critiqued, either by
the institutions we submit to or the
peer-reviewed academic papers we
publish in, we have an absolute focus
on quality control. This is important
as it preserves not only our reputation
but also that of the pharmaceutical
companies we represent.
One of our greatest challenges is the
way pharmaceutical companies try
to find partners, especially through
highly standardised procurement
processes. We are in a very specialist
field, and when pharmaceutical
companies choose to work with
us, they are essentially buying our
expertise, and that expertise is
delivered in very close collaboration
with the teams who have been
working on a new product for
many years. As our solutions are all
individually tailored, it can be difficult
to demonstrate the value of our
complex offering to procurement
teams who will have no involvement
in the projects they are procuring.
This is exacerbated by lengthy
procurement processes; rather than
our core focus remaining on health
economics, we now have to spend a
significant portion of time working
through these processes. We have
had to hire and build teams to help us
navigate through these challenges.
Beyond this, as an SME business,
the payment terms imposed on us
by our large multinational clients,
sometimes as long as 90 days and
above, can have a significant impact
on ourcashflow.
A global future
As our growth has been based on the
strength of NICE and UK standards, if
the UK becomes marginalised post-
Brexit, there could be a negative
effect on our business. In particular,
the impact of the move of the
European Medicines Agency to the
Netherlands has yet to be determined.
We have, however, been preparing
for all potential outcomes and have
started building out our US and
European businesses as these are
large, well-developed markets that
are moving towards the cost–benefit
analysis approach championed
byNICE.
Over the next five years, we anticipate
there will be key developments in the
US market. Traditionally, because of
their insurance-based health system,
all pharmaceutical companies needed
to do was demonstrate that a drug
worked and they would leave it to
free market economics to determine
how much they would be paid for it.
However, as the US moves towards
European HTA models, they are
increasingly looking for partners to
assess value for money and compare
drugs with their competitors before
payers approve them for use. Because
of our background, and our expertise
in these European models, we feel
we are ahead of the curve. If we
are able to harness this movement,
we anticipate major growth and an
exciting future for our company.
Employees meeting in
one of our Sheffield
office meeting rooms
We have started
building out our
US and
European
businesses as
these are large,
well-developed
markets that are
moving towards
the cost–benefit
analysis
approach
championed
byNICE
BEST PRACTICE SPONSOR 2020
THE PARLIAMENTARY REVIEW
Highlighting best practice
10 | BRESMED
Driving global growth
As the company has developed, we have
expanded our services to include the
writing of submission dossiers, statistical
analysis on clinical data and strategic
planning support. This has meant that
rather than only being involved at the
end of the drug development process,
we often get involved much earlier,
supporting clinical trial design to ensure
that the most appropriate health and
economic outcomes research – or
HEOR – data are collected to support
not just the licensing process but also
the later reimbursement case.
NICE has always been at the forefront
of health technology assessment – or
HTA – with many of the standards and
processes for evaluating the impact
of new treatments developed by NICE
and the academic institutions it has
partnered with. Within the industry,
NICE has been recognised as the
“gold standard” in HTA, which has
meant that many pharmaceutical
companies have decided to start
their reimbursement journey in the
UK – the rationale being that if their
model is robust enough for NICE, they
will be able to meet the standards
for reimbursement applications in
other countries where the process is
generally less rigorous. Our expertise
has been developed to meet the high
standards of NICE and, as a result,
we have been perfectly positioned
to provide HEOR services for other
markets around the world.
This growth has seen our team
increase from just me to over 165
employees globally, with around 100
of those in the UK. Alongside our UK
base, we also have offices in India,
Ireland and the Netherlands and have
recently set up in Las Vegas in the
US. Our global expansion, and the
establishment of these offices, has
been possible due to the success of our
UK operations.
Keeping academic rigour at
the forefront
Our key strength, and something
which has always been an integral
part of our company values, is our
academic rigour. We adopt emerging
methodology and develop our own,
all the while improving our skillsets
and retaining academic excellence
at the forefront of what we do. To
support this, we have established
rigorous recruitment standards and
have invested considerable time and
expense in their development. By
keeping methodological excellence at
our core, and establishing strong links
with key universities, such as Sheffield
and York in the UK and Colorado and
Utah in the US, we have been able to
achieve success. As we have expanded,
we have sought to build similar
academic links in other countries
around the world.
These links with universities are
essential to develop methodology
and are beneficial for both parties.
Universities are always searching for
issues within the field to research,
and we are always looking to
findsolutions.
Members of our board,
clockwise from top
left: Steve Beard, Kunal
Srivastava, Nic Brereton,
Becky Brereton, Ron
Akehurst, Sue Latimer
and Dawn Lee
Our expertise
has been
developed to
meet the high
standards of
NICE and, as a
result, we have
been perfectly
positioned to
provide HEOR
services for
other markets
around the
world
11BRESMED |
BUSINESS SERVICES
Given that everything we produce
will be publicly critiqued, either by
the institutions we submit to or the
peer-reviewed academic papers we
publish in, we have an absolute focus
on quality control. This is important
as it preserves not only our reputation
but also that of the pharmaceutical
companies we represent.
One of our greatest challenges is the
way pharmaceutical companies try
to find partners, especially through
highly standardised procurement
processes. We are in a very specialist
field, and when pharmaceutical
companies choose to work with
us, they are essentially buying our
expertise, and that expertise is
delivered in very close collaboration
with the teams who have been
working on a new product for
many years. As our solutions are all
individually tailored, it can be difficult
to demonstrate the value of our
complex offering to procurement
teams who will have no involvement
in the projects they are procuring.
This is exacerbated by lengthy
procurement processes; rather than
our core focus remaining on health
economics, we now have to spend a
significant portion of time working
through these processes. We have
had to hire and build teams to help us
navigate through these challenges.
Beyond this, as an SME business,
the payment terms imposed on us
by our large multinational clients,
sometimes as long as 90 days and
above, can have a significant impact
on ourcashflow.
A global future
As our growth has been based on the
strength of NICE and UK standards, if
the UK becomes marginalised post-
Brexit, there could be a negative
effect on our business. In particular,
the impact of the move of the
European Medicines Agency to the
Netherlands has yet to be determined.
We have, however, been preparing
for all potential outcomes and have
started building out our US and
European businesses as these are
large, well-developed markets that
are moving towards the cost–benefit
analysis approach championed
byNICE.
Over the next five years, we anticipate
there will be key developments in the
US market. Traditionally, because of
their insurance-based health system,
all pharmaceutical companies needed
to do was demonstrate that a drug
worked and they would leave it to
free market economics to determine
how much they would be paid for it.
However, as the US moves towards
European HTA models, they are
increasingly looking for partners to
assess value for money and compare
drugs with their competitors before
payers approve them for use. Because
of our background, and our expertise
in these European models, we feel
we are ahead of the curve. If we
are able to harness this movement,
we anticipate major growth and an
exciting future for our company.
Employees meeting in
one of our Sheffield
office meeting rooms
We have started
building out our
US and
European
businesses as
these are large,
well-developed
markets that are
moving towards
the cost–benefit
analysis
approach
championed
byNICE

www.bresmed.com

This article was sponsored by BresMed. The Parliamentary Review is wholly funded by the representatives who write for it.