Director of Media & Communications, Association of the British Pharmaceutical Industry (ABPI). Jack leads the ABPI's efforts to communicate the pharmaceutical industry's story in the UK, working at the intersection of policy, public health, and industrial strategy.

If you've worked in pharma or market access, you've likely encountered the ABPI. But for those outside the industry, the organisation is often poorly understood—or dismissed as just another lobbying group. Jack offered a more nuanced picture.

Founded over a century ago (originally and somewhat delightfully known as "The Drug Club"), the ABPI represents companies across the pharmaceutical lifecycle—from early-stage research through clinical development to NHS adoption. Its stated mission: to make the UK the best place in the world to research, develop, and access innovative medicines.

One of the ABPI's most consequential roles has been negotiating the commercial framework between the pharmaceutical industry and the NHS. For roughly 70 years, the organisation has worked with government to ensure that the use of new medicines remains financially sustainable while preserving patient access. That tension—sustainability versus access—runs through virtually everything the ABPI does.

When I asked Jack about the "lobbying group" perception, he pointed to the ABPI's Code of Practice—a self-regulatory framework that in some areas goes beyond what UK law requires. A central piece of this is Disclosure UK, a public, searchable database that records all transfers of value between pharmaceutical companies and their stakeholders, from conference sponsorships and research funding to payments to patient organisations.

The underlying philosophy, as Jack described it, is straightforward: the industry benefits when it is trusted, and trust requires transparency. The ABPI doesn't represent any single company—it represents the sector. And the sector's reputation depends on showing exactly how those relationships work and what they produce.

The conversation naturally turned to NICE. Jack's position was measured: NICE does a genuinely difficult job—making decisions that can determine whether patients live or die—and it broadly does it well.

But the ABPI's concern isn't really with NICE itself. It's with the framework NICE is given to work within. That framework is ultimately a political decision about resource allocation—and it's a framework that hasn't been updated in a very long time.

What's worth noting from this conversation is the broader principle Jack articulated: cost-effectiveness is an important tool, but it is not the only tool—and it is not uniformly applied across the NHS. Medicines are held to a uniquely rigorous cost-benefit standard that many other NHS interventions simply aren't subject to. As Jack pointed out, if you applied strict cost-per-QALY logic to everything the NHS does, you'd run into some deeply uncomfortable conclusions about, say, neonatal care or mental health services.

This is where the conversation moved from principle to data—and the picture is concerning.

The UK spends roughly 9% of its health budget on branded medicines. The average across comparable developed countries—Canada, Japan, France, Germany, the US—sits around 14%. The UK used to be in line with that average. It no longer is.

Are outcomes better as a result of spending less? Jack was clear: no. The UK tends to sit near the bottom of OECD rankings for treatable and preventable disease. Is medicines spending the sole cause? Almost certainly not—but it's likely part of the picture.

Perhaps more telling is what's happening in the appraisal process itself. Termination rates—companies withdrawing from the NICE process before completion—have doubled when comparing the most recent five-year block to the one before it. And that figure only captures the companies that at least tried. The number that never submit to NICE in the first place is much harder to quantify, but Jack suggested it's growing.

There's also a subtlety in the headline NICE approval figure (~82%). A "positive" recommendation doesn't necessarily mean a medicine is available to everyone it could benefit. NICE may restrict access to a narrower patient population than the one for which the drug was originally licensed. Positive, in this context, can mean anything from full coverage to a highly restricted subset of eligible patients.

When I asked Jack what he's most excited about, the answer wasn't pricing or policy—it was data.

The UK sits on a wealth of health data, collected over decades through its universal healthcare system. But unlocking that data for research and drug development has been, as Jack put it, a story of good rhetoric with limited follow-through. That may finally be changing.

The ABPI has been working with government and other stakeholders on frameworks for using health data in research—safely, securely, and with patient trust at the centre. Jack described this as being "on the absolute cusp" of becoming reality.

He drew an analogy from his previous career in financial services: mobile banking adoption in parts of Africa leapfrogged Europe, precisely because Africa didn't have the legacy infrastructure holding it back. The UK's health data infrastructure faces a similar challenge—what Jack called "the tyranny of legacy systems." GP practices still hold records on formats nobody can read anymore. Digitising and standardising all of this requires serious investment.

But if the UK gets this right, the payoff could be transformative: a genuine competitive advantage in attracting pharmaceutical R&D, and materially better outcomes for patients.

At ~9% of the health budget versus a ~14% average among peers—without corresponding improvements in outcomes.

A "positive" NICE recommendation may cover a much narrower patient population than originally licensed, and termination rates tell a story that top-line figures don't.

If legacy infrastructure and trust issues can be resolved, the UK is uniquely positioned to leverage its data for research and drug development at scale.