Disease Management, the NHS and the Pharmaceutical Industry

Disease management is a term with multiple and ambiguous meanings. For some, it is purely a form of managing care. For others, it is ‘strategic planning’ by the pharmaceutical industry to market its products in a different way. In between these two ends of the semantic spectrum are a wide variety of interpretations and usage. Forms of health care management exist that embody all the principles of disease management, but which are given a different label. In this report, we explore different notions of disease management and consider their relevance to the NHS. In doing so, we draw on a review of the medical literature on disease management, which comes mainly from the US, and on a survey we have conducted among senior personnel in the NHS and the UK pharmaceutical industry (see Appendix 1 for details of our survey). The report is structured as follows. ● In section 1, a working definition for disease management is assembled and the role of the pharmaceutical industry considered. ● In section 2, the background to disease management and its origins in the US are described. Some practical examples of disease management in the US are outlined. ● In section 3, the relevance of disease management to the NHS is explored. Viewpoints on the potential for pharmaceutical industry involvement in disease management are presented. The potential barriers to the development of disease management in the NHS are then considered. ● In section 4, examples of ‘joint ventures’ in the NHS are set out, based largely on a ‘joint venture’ survey (see Appendix 2), that followed on from results of the ‘disease management’ survey. ● Finally, section 5 addresses the future for disease management in the NHS.