Oli Hudson, content director at Wilmington Healthcare, explores the medtech funding stream that went live on 1 April 2022.
The medtech funding mandate (MTFM) isn’t a new idea; for some years there has been a fast-track stream of money for innovative products that has gone by various different names. It’s ringfenced funding for innovative products.
The MTFM is now going into its second year, after 2019’s NHS Long Term Plan committed to accelerate the uptake of selected innovative medical devices, diagnostics, and digital products to patients faster and build on the pre-existing innovation technology payment.
The criteria for inclusion seem pretty straightforward; funding devices, diagnostics or digital products that are effective, NICE approved, cost-saving and affordable to the NHS.
The actual wording of the 2022/23 criteria is:
- Effective: demonstrated through positive NICE Medical Technology Guidance (MTG) or Diagnostic Guidance (DG), published by 30 June 2021.
- Cost-saving within three years of implementation: as demonstrated by NICE modelling.
- Affordable to the NHS: the NICE budget impact analysis total costs should not exceed £20 million in any of the first three years.
The significant one here is the change in the cost saving criterion, where a product now has three years to make a cost saving difference, rather than previously, which was one year - the idea being to make more technologies eligible for inclusion.
Which products are already supported by the mandate – and which ones have now been included?
The first year of the MTFM supported four products:
Placental growth factor-based testing (PlGF) – a blood test to rule out pre-eclampsia in pregnant women, SecurAcath – for securing percutaneous catheters, HeartFlow, which creates a 3D model of a patient’s coronary arteries and assesses the extent and location of blockages, and gammaCore – a handheld device which alleviates the symptoms of severe cluster headaches.
The second year’s mandate – which goes live 1 April 2022 - has now included four technologies involved in prostate treatment, UroLift, GreenLight XPS, Rezum and the PLASMA system, and three for improving patient experience during procedures, the XprESS multi-sinus dilation system, the Thopaz+ portable digital chest drain system, and the Spectra Optia Apheresis System, an apheresis and cell collection platform for the treatment of sickle cell disease.
Why have these new technologies been included?
All the products selected by NHS England, in its words, “enable high quality outcomes from treatment and depend on fewer resources, reducing theatre time and length of stay so that more patients across England can be treated quicker”.
Note these three key phrases: fewer resources, reducing theatre time and length of stay – the need for all of these elements cannot be divorced from the crucial need to address the elective care back log, by improving productivity and patient throughput wherever possible.
However, not to be ignored is the emphasis on high quality outcomes, nor the central factor of patient experience in four of the new technologies.
Matt Whitty, director of innovation, research and life sciences at NSH England and also chief executive of the innovations body the Accelerated Access collaborative, presented a breakdown of what makes an effective MTFM product, dividing benefits into two categories: for patients, and for systems.
Aside from those mentioned above, patient benefits would include hospital avoidance. There’s an emphasis on heath inequalities, for products that reduce the inaccessibility gap and help ensure proven innovative treatments are available to all.
System benefits would be helping the NHS recover from COVID-19, that products are available on Supply Chain, reducing the need for procurement contracts, and that with full implementation, the successful product would deliver £25 million of savings over five years.
What’s the role of AHSNs in this?
The 15 regional Academic Health Science Networks (AHSNs) are the delivery and implementation arm of the MTFM. Every AHSN will support every MTFM technology.
The present themselves in this process as ‘honest brokers’ between suppliers and systems, understanding how innovative tech can fit into systems and providing technical advice. AHSNs will walk clinicians through the evidence for each of the MTFM products, demonstrate economic modelling to decision makers and even help suppliers and involved clinicians develop a business case - rapidly counteracting most of the obstacles normally faced by suppliers locally.
Conclusion
So, it’s clear that being included in the MTFN is a positive position for suppliers to be in – but how realistic is it that next year’s mandate will further widen the scope of what will be included?
Gradual improvement on existing tech will usually eventually find a footing in the NHS, but this platform seems clearly intended for gamechanger products, demonstrated by the number of self-contained ‘systems’ in the initiative which advance the science of clinical practice and medical management itself. More and more, this is going to be the kind of thing the NHS is looking for.
It's notable too that many of the product hooks stated as desirable by the NHS leaders of the MTFM are not to the organisation, but to the system; increasingly, medtech suppliers are going to have to look at their product benefits to population health and cross-organisational pathways, as a standard feature of business practice.
