The pharmaceutical manufacturing sector has a high rate of innovation. The never-ending quest for better patient outcomes is the mother of this invention, with pharmacists and scientists continually striving for improved treatments and processes that give patients that little bit more relief.
The major pharmaceutical brands by no means have a stranglehold on this, and up and down the country there are far smaller businesses and research units dedicated to nothing else. This brings us to the ostensibly quiet little market town of Corsham in Wiltshire.
In a trading estate on the edge of the town, you can find Bath ASU, a business only established as a commercial entity in 2006, dedicated to providing the best possible treatment to cancer patients. Entirely privately funded, the ethos of the business has been founded on innovation – an approach that has resulted in it becoming a rapidly growing significant local employer.
The core business of Bath ASU surrounds highly trained production staff operating under rigorously controlled processes in aseptic facilities, transferring doses of chemotherapy drugs into ready-to-administer devices, which are then packaged and dispatched to hospitals and nurses for home administration.
The business founders soon identified a demand to specialise in biologics – drugs that have been growing in importance for some years, but suffer from a short shelf life. Commonly as little as eight to 24 hours for specialist treatments that can cost several thousands of pounds each. This was an inherent weakness that had a profound impact on not just patient outcomes, but also on the hospitals’ capacity and ability to treat patients effectively.
Bath ASU was determined to find a way to overcome this critical weakness – and, in 2011, established a research and development unit, working in collaboration with the University of Bath, specifically tasked with finding a solution.
To be successful, the R&D unit had to prove that it was technologically possible, and change the way NHS hospitals operate. After years of dedicated work, the NHS Pharmaceutical Quality Assurance Committee ratified the approach by adopting a new standard, enabling Bath ASU to offer biologics to the market with shelf lives extended up to a maximum of 84 days.
The effect on cancer patients and on the hospitals that treat them has been profound.
“This has transformed our entire approach because we are now able to purchase high use lines essentially as batch products and keep them on the shelf as stock,” explains Andrew McKendrick, who is Lead Pharmacist – Cancer & Aseptic Services and a Pharmacist Independent Prescriber at Weston Area Health NHS Trust.
“We have no in-house unit of our own and the extended stability allows us to outsource as batch, which has tremendous benefits to staffing capacity, saving time and resource and enabling us to focus on the patients rather than on the drugs.
“There is a real added benefit here in that the extended shelf life dovetails beautifully with a directive from NHS England which has called for dose banding and standardisation of chemotherapy treatments. This means that patients are assessed according to their illness and personal criteria and prescribed drugs accordingly.
“Extending the shelf life means that we can keep more drug lines as stock and administer them to a range of patients within the prescribed dose band. Extending the shelf life has directly made this possible and the result is that the entire process is improved, with much greater flexibility and less procurement pressure, and far more patient focus.
“We’re the smallest acute hospital trust in England and we can’t afford to have waste in the services we provide, especially with the very high cost of many of the specialised chemotherapy drugs.
“Before the advent of the extended shelf life products it was common for us to waste an average of £5,000 a month because patients would be too unwell to be treated. The short shelf life innate in the drugs meant that we had to destroy them and order replacements. The extended shelf life products have saved, typically, at least 80% of this wastage, and that has made a significant difference to the way we operate.
“More importantly though, the products have transformed the patient experience. Previously, patients would have to wait, commonly, for three or four hours because we wouldn’t start to prepare their treatments until we knew they were going ahead. With long shelf life products we can plan several days ahead and book in more patients every day. They can turn up, go straight into pre-med, have the drugs administered and then go home. If they aren’t well enough to attend or are assessed on the day as not fit for treatment the product isn’t wasted, it goes back onto the shelf and can either be used for the same patient at a later date or given to a different patient.
“The whole process is considerably streamlined, far less stressful for the patient and saves significant amounts of time and money for the hospital.”
Down at the Royal Cornwall Hospital in Truro, Head of Pharmacy Technical Services James Henderson faces a different challenge.
“We cover a large geographical area, from the Scilly Isles to Tintagel, and working with the Hope for Tomorrow Charity have established a mobile treatment centre so that chemotherapy can be administered to patients in different locations rather than them having to travel to the hospital,” he explains. “Having products with extended shelf lives allows us to order in advance, freeing up production capacity. The result of all this is that the range and number of patients using this mobile service is increased.
“The extended shelf life products have significantly contributed to what is a fundamental change in the approach to chemotherapy treatment throughout this region. They’ve provided us with far greater freedom to plan capacity and contingency resulting in a significant reduction in wastage and a much-improved experience for the patient.”
Bath ASU’s Director Chris Watt says that the Queen’s Award for Innovation is a significant milestone for Bath ASU. “It is extremely gratifying to see the dedication and commitment of the team directly resulting in a better experience for cancer patients, and providing a major helping hand for oncology units in hospitals throughout the country.
“The recognition of all of this with the Queen’s Award is a tremendous reward, not just for the R&D team, but for the entire business and every single member of staff. We are all delighted and deeply honoured.”