Memorandum by Wyeth Pharmaceutical
Wyeth is pleased to respond to the call for
evidence from the House of Lords Science and Technology Committee
on fighting infection. Wyeth has a long history of pioneering
developments in pharmaceuticals and biotechnology, with leading
products in the areas of women's healthcare, neuroscience, musculoskeletal
disorders, cardiovascular therapy, vaccination and infectious
disease, haemophilia, immunology and oncology. Wyeth's vaccines
and infectious disease franchises share a common mission to reduce
the number of serious illnesses and deaths from bacterial and
viral infections and to address the growing problem of bacterial
resistance to existing treatments.
In recent years, Wyeth Vaccines has developed
some of the most innovative vaccines in the health care arena.
Our Research and Development focuses on the needs of communities
around the world. The national immunisation campaign began ahead
of schedule in autumn 1999, following the availability of Wyeth's
meningococcal group C vaccine a year earlier than planned allowing
children and young people in Britain to become the first in the
world to benefit. This was made possible through the collaboration
between the Department of Health, regulatory agencies and other
official bodies. This is an excellent example of what can be achieved
by open communication to achieve a common goal.
We are proud of the impact Wyeth has had on
both childrens and adults lives and we are dedicated to continually
developing vaccines so that they can have a healthier future.
1. What are the main problems facing the
surveillance, treatment and prevention of human infectious disease
in the United Kingdom?
As a vaccine manufacturer we have identified
several key problem areas:
Inconsistencies in implementation
Relationship between industry and
Variations in compliance and commitment within
different regional surveillance systems are a major cause of under-reporting
of notifiable infections and the consequent under-estimation of
the disease burden. This affects many important preventable conditions.
An integrated surveillance system for the whole of the UK, ie
a national framework, would more accurately quantify disease impact.
Moreover, compliance with such a system would provide a powerful
tool to assist policy makers.
Implementation of vaccine policy outside the
childhood immunisation programme is variable. The factors that
contribute to this situation include:
The system of financial incentives
for meeting targets, eg fees for flu vaccination in "at risk"
patients under 65 years of age are offered to GPs in Wales and
Northern Ireland but not in England and Scotland.
Inadequate national tracking systems
mean that implementation of national guidance and recommendations
is a primary care responsibility, eg immunisation of "at
risk" populations with pneumococcal vaccines.
The Joint Committee on Vaccination and Immunisation
(JCVI), an independent statutory committee, has been advising
the UK Health Minister on immunisation policy since 1963. Until
recently the committee's constitution and meeting minutes were
not made public. We welcome the introduction of the new JCVI website
as we believe this will contribute towards better informing all
stakeholders and helping to restore public confidence in vaccines.
We hope that this heralds a new era of communication in which
meeting agendas will be made public and vaccine manufacturers
will be invited to contribute where appropriate. Guidelines for
decision-making would enable prioritisation of manufacturers'
research activities in order to facilitate the earliest possible
availability of new disease management strategies.
Furthermore, greater communication would allow
the identification of common goals for educational programmes
aimed at both healthcare professionals and the general public.
Wyeth already develops and implements such educational initiatives
to support customers in preventing antibiotic resistance and implementing
Whilst acknowledging the need to ensure the
Department of Health's independence, we would welcome greater
partnership in the development and implementation of educational
Ability to implement NICE guidance is consistently
flagged as an area of great concern. Although NICE does not preside
over vaccination policy, pharmaceutical utilisation in disease
management programmes such as that for haemophilia raises the
question of post code prescribing and therapy concordance. Wyeth's
portfolio includes recombinant factor VIII which has been the
subject of such deliberation.
2. Will these problems be adequately addressed
by the Government's recent infectious disease strategy, Getting
Ahead of the Curve?
We welcome the strategy document as it provides
a vision to work towards. However we appreciate that the next
steps need to be put in place to demonstrate how this will be
implemented. Specifically we look forward to understanding the
priorities for vaccine development. We hope all the countries
in the UK adopt the strategy document so that cohesive implementation
is achieved. To this end, the process and communication needs
Wyeth looks forward to contributing towards
this process in conjunction with other industry partners which
will enable us to match our R & D pipeline to strategically
3. Is the United Kingdom benefiting from
advances in surveillance and diagnostic technologies; if not,
what are the obstacles to its doing so?
Wyeth is happy to participate in a working party
to collaborate on technological projects related to effective
development, production and distribution of our portfolio to meet
the needs of all stakeholders.
Where advances in surveillance and diagnostic
technologies impact upon these factors we feel that the greatest
obstacle would be lack of open and timely communication.
4. Should the United Kingdom make greater
use of vaccines to combat infection and what problems exist for
developing new, more effective or safer vaccines?
As a vaccine manufacturer, we believe that the
impact of vaccination on the prevention of disease has been clear
and significant in public health terms. Regulatory conditions
sometimes result in the delay in the implementation of new vaccination
strategies. This is especially applicable in the era of European
National review policy also has significant
potential to cause a delay in pursuing new vaccine opportunities
due to the requirement to re-assess the safety and efficacy of
any new vaccine in the context of incorporating it into the existing
national immunisation schedule. Delay in the introduction of a
routine immunisation programme for infants and children against
invasive pneumococcal diseases such as meningitis is an example
Transparency of decision-making by bodies such
as JCVI is vital to ensure public confidence.
5. Which infectious diseases pose the biggest
threats in the foreseeable future?
Getting Ahead of the Curve identifies
developments for existing vaccines and the development of new
vaccines. Priorities need to be set so that Wyeth's R&D investment
is focussed on the right areas.
We agree with Getting Ahead of the Curve
with regard to antimicrobial resistance but are unsure as
to how new threats are identified. We look forward to clarification
on this matter. Antimicrobial resistance in primary care was flagged
as a priority issue through the SMAC report. There are numerous
reports of emerging antibiotic resistance to common hospital pathogens,
eg MRSA, VRE, Colstridium difficile and ESBL's. Whilst factors
such as irrational prescribing of antibiotics, poor infection
control and use of antibiotics in animal fees contribute to this
issue, Wyeth actively supports research to reduce the rapid emergence
of these new resistant bacteria.
Wyeth's treatments in areas such as H pylori
eradication, infection control and immunisation are all vulnerable
to cuts in health service expenditure when targets are set for
other areas, such as dealing with patient waiting lists. This
impacts upon our ability to invest in new areas which face emerging
issues and as such might limit the future armoury available to
6. What policy interventions would have the
greatest impact on preventing outbreaks of and damage caused by
infectious disease in the United Kingdom?
Wyeth would welcome a more active engagement
of the pharmaceutical industry with all stakeholders. Collaboration
between ourselves, the Department of Health and health professions
has led to the effective introduction and promotion of the Meningitis
C programme. We look forward to greater transparency and cooperation
in the future in order to protect the public.