Our cardio-metabolic team is focused on a disease area that has a worse five-year prognosis than a number of major cancers: heart failure, a debilitating and life-threatening condition.
‘Heart failure’ means that the heart is failing to pump enough blood around the body. It usually occurs because the heart muscle has become too weak or stiff to work properly, often as a result of a previous heart attack or poorly controlled blood pressure. It is most commonly first diagnosed in people aged over 70, but is also often found in the 45-75 year age group.
Around 900 000 people in the UK today have heart failure and almost as many people have damaged hearts but no symptoms of heart failure. The outcome for people with heart failure remains poor. 30-40% of patients diagnosed with heart failure die within one year - but thereafter the mortality is less than 10% per year. Heart failure treatment costs the NHS around £2 billion a year, with 70% of these costs as a result of hospitalisation. 
Heart failure can be an acute or chronic (long term) condition. Acute cases need immediate hospitalisation into a specialist coronary care unit. Although often not curable, a number of treatments exist that can improve survival and reduce hospitalisations, as well helping the day to day symptoms.
Novartis is currently working to develop innovative new therapies that improve outcomes for patients with both acute and chronic heart failure. We work closely with healthcare professionals to raise awareness of heart failure, support education and service development. For example:
Working with Clinical Commissioning Groups (CCGs) in England, Health Boards in Scotland and Wales, and Health and Social Care Trusts in Northern Ireland to raise the priority of heart failure
Gaining advice from medical experts on how to improve patient outcomes in heart failure through the optimisation of heart failure services
Supporting the education of healthcare professionals through the provision of grants to support academic meetings
Providing industry-sponsored medical education activity at scientific congresses
For people with skin conditions, of all severity, the ultimate goal of any treatment is to achieve clear skin. Our dermatology team works with people living with a number of severe skin conditions and associated disorders, including psoriasis and chronic spontaneous urticaria. These conditions are often painful and unpleasant, and can also have a huge impact on patients’ quality of life, especially as they can occur spontaneously and re-occur for many years. Patients with these disfiguring conditions can find it hard to go out of their homes, go to work, carry out normal leisure activities and simply enjoy life.
The prevalence of skin conditions is high. Around a quarter of the population will visit their general practitioner with a skin problem every year . Understanding about these conditions is low and many patients wait years to get appropriate treatment. However, with the right treatment approach, many patients can have big reductions in the frequency and severity of these distressing conditions and, in many cases, can lead an essentially normal life.
Our investment in this area is focused around education on the conditions, large-scale clinical trials to establish best practice in the use of new therapies and creation of extra capacity in the NHS to ensure that patients can access them. Some of our funded programmes include:
A multi-million pound UK clinical trial among psoriasis patients.
Assisting the NHS in redesign of clinical pathways to optimise service levels and treatment availability.
Supporting increases in NHS capacity by providing assistance to health care professionals providing treatment to patients.
1) Schofield JK, Grindlay D, William HC. Skin conditions in the UK: a health needs assessment. 2009. Centre of Evidence Based Dermatology, University of Nottingham.
COR15-C020a June 2015
Neuroscience – taking control of Multiple Sclerosis (MS)
The neuroscience team at Novartis is committed to ensuring that patients with multiple sclerosis (MS) receive the right treatment at the right time. MS is a progressive disease affecting the central nervous system and is typically diagnosed in people aged 20 to 40.
Although MS symptoms vary significantly from patient to patient, it typically has a big impact on quality of life, and both physical and cognitive abilities, including the ability to work. Up to 80 per cent of people with MS stop working within 15 years of its onset . MS cannot yet be cured but a range of treatments are available which can slow down or manage its progression, enabling many MS patients to take control of their condition and improve their quality of life.
However, like many complex conditions without cures, there is pressure on the number of specialist neurologists available to provide the in-depth assessment, treatment and care of people with MS.
Our focus is on increasing the number of people who can access NICE-approved MS therapies by working with the NHS, researchers and patient organisations to minimise issues which act as a barrier to diagnosis and treatment. Some of the initiatives we are supporting include:
Working jointly with an NHS Trust to improve facilities for monitoring treatments and disease progression.
Developing an industry first smartphone and tablet app, SymTrac, that helps both patients and carers to monitor symptoms and identify relapses. This is a UK patient-led initiative, by and for people with MS.
Offering an independent service to review MS patients’ medical notes to ensure management of their MS can be optimized.
Our oncology team is a global leader in providing a broad range of innovative therapies to help improve the lives of patients with cancer and non-cancerous rare diseases. The team are dedicated to helping deliver therapies to more patients in their fight against cancer and rare disease.
Novartis now offers one of the largest portfolios of medicines in cancer, blood disorders and rare diseases. From 2015, there are more than 25 potential new medicines in development with more than 25 000 patients currently being enrolled into clinical trials globally, with the goal of improving patients’ lives even more than we can today.
Our approach is driven by a distinctive scientific and clinical strategy focused on ‘precision oncology’: we research how cancer develops on a genomic level and then develop drugs to hone in on those targets. Novartis is also working in the potentially revolutionary new area of cancer immunotherapy where the patient’s natural immune system is used to fight cancer. Novartis Pharmaceuticals invests 17% of its global turnover in R&D and, in the area of cancer, these efforts begin in the Novartis Institute for BioMedical Research (NIBR).
We are working in partnership with the NHS on a number of initiatives to improve patients’ lives:
Working with healthcare professionals within the NHS to create a template for a dedicated clinic for a rare disease (tuberous sclerosis complex), based in Cardiff. Patients in Wales with this serious and life-long condition that affects many parts of the body, had no specialised service to manage their rare disease. Some patients are very young children with benign brain tumours that can severely impact their quality of life and require integrated, specialised care. With a year’s funding from Novartis, the clinic launched in December 2014.
By supporting nurses in specialised hospitals, as in Scotland, we are helping to improve the care of patients with pancreatic neuro-endocrine tumours (pNETs). These are cancers of the endocrine and nervous systems which are considered ‘rare’ cancers and a team of highly specialised healthcare professionals is necessary for diagnosis and treatment. The nurses deliver education and practical solutions to patients for managing any unwanted side effects and to improve adherence to their treatment regime. Committed to supporting the redesign of patient services, these hospitals can become Centres of Excellence, attracting resources and new patients who will significantly benefit from optimal care provided by a multidisciplinary team.
Working with York University and the NHS’s Haematological Malignancy Research Network database to fully understand and map the care of patients with a number of different blood cancers from diagnosis through to treatment. This will also enable the NHS to better evaluate future medicines through the collection of real-world evidence.
COR15-C020f June 2015
Respiratory – controlling the impact of asthma
Our respiratory team works with therapies that help patients to manage the effects of severe allergic asthma. According to Asthma UK, asthma affects over 5 million people in the UK . Every day in the UK an average of 3 people die from an asthma attack . Allergic asthma is a common type and occurs when a patient’s asthma is triggered by allergens (substances which produce an abnormally vigorous immune response) such as pollen, dust mites or mould.
Approximately 5-10% of asthma patients have severe asthma and a large proportion of these patients will have severe allergic asthma . It can make everyday life very difficult, as exacerbations (an increase in the severity of a disease or its signs, “asthma attacks”) can be unpredictable and life threatening. People with severe allergic asthma live with frequent, often daily, severe asthma symptoms and the risk of life threatening exacerbations. Their asthma is difficult to control and they often find it difficult to work, look after their families or to do routine activities. This has a high impact on NHS resources, due to the frequent Emergency Department (ED) visits and hospitals admissions.
With the right diagnosis and appropriate treatment and management the impact of severe allergic asthma can be substantially reduced. Apart from the obvious benefits of fewer or less severe exacerbations, benefits include improvements to overall wellness, reduced dependence on other medicines such as steroids, and fewer ED or GP visits. However, clinical resources with the right training and experience to guide suitable patients from primary care facilities to specialist units can be in short supply. According to The National Review of Asthma Deaths  “…people with severe asthma were not always referred to a specialist when they should have been.”
Our work focuses on a number of areas, including education of medical professionals and assisting with medicine administration by providing trained nurse support.
Our projects include:
Working with hospital emergency and respiratory departments to conduct reviews and audits of their data on the intake of patients with severe asthma exacerbations, with the aim of comparing current activity with best practice guidelines.
Training events that allow doctors and nurses to participate in lectures and workshops that contribute to their professional development, and knowledge and understanding of severe allergic asthma.
Gaining a better understanding of the efficacy of treatments in patients by supporting “real world” studies across multiple locations.
Most people take good eye health for granted, until they have a problem. Eyesight is so critical to almost every aspect of daily life that when eye health problems do occur they can be devastating. Imagine the impact of being unable to read, drive, make a cup of tea or use everyday items such as a computer or telephone.
Approximately 2 million people are living with significant sight loss in the UK and 50% of this sight loss is avoidable .
Our ophthalomology team focuses on conditions which affect the retina, the critical, light-sensitive area at the back of the eye. Our medicine is used in a range of conditions including wet age-related macular degeneration (wet AMD) and visual impairment secondary to diabetic macular oedema (DMO), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) and myopic choroidal neovascularisation (mCNV) . All of these affect the retina and can cause vision loss or even blindness.
Wet age-related macular degeneration (wet AMD)
There are over 500 000 people with age-related macular degeneration in the UK and approximately 10% of these have wet AMD. This accounts for 40 000 new cases per year [3,4].
It is estimated that the number of people with AMD will increase to 679 000 by 2020 as the population ages .
Diabetic macular oedema (DMO)
In 2013 the number of people diagnosed with diabetes in the UK was 3.2 million .
DMO is one of the main causes of vision loss and occurs in a small proportion (approximately 2.6%) of diabetic patients, but this equates to approximately 80,000 people in the UK[6,7].
Branch retinal vein occlusion (BRVO) and Central retinal vein occlusion (CRVO)
BRVO is three times more common than CRVO. In England and Wales, the number of people diagnosed with visual impairment due to macular oedema secondary to either BRVO or CRVO is quite low.
Eye health problems can affect people of any age but are most common as we get older. As our population ages, the number of people looking for help with these conditions continues to grow. Our work with the healthcare community is therefore focused on improving patient care, providing education and support to ophthalmology healthcare professionals, and working with NHS organisations to provide sustainable eye health services through a range of initiatives:
Excellence in Ophthalmology is a programme of needs-based medical education, training and support for the ophthalmologist community, with over 400 healthcare professionals trained to date .
A Clinical Research Training Fellowship Programme supported by the Medical Research Council, Royal College of Ophthalmologists and Novartis, which aims to foster a group of UK researchers dedicated to clinical ophthalmology.
Joint working projects with the NHS which address patients’ changing needs, improve services and bring care into the heart of communities.
As part of our ongoing commitment to ensure that eligible patients can access innovative retinal medicines, we have put in place a patient access scheme which enables the NHS to benefit from significant savings in medicine costs.
Transplantation and immunology – preventing rejection
The products within the Novartis transplantation portfolio support healthcare professionals to help the often critically ill patients who receive organ transplants to have successful, life-saving operations, through drugs that prevent rejection of transplanted organs. Novartis was the first company to market with a modern immunosuppressant and has continued to innovate in this area.
Organ transplants are a highly-specialised area of medicine and the number of operations taking place is not as high as might be assumed. In the UK, for example, there are around 800 liver and 2 000 kidney transplants per year . Availability of suitable donor organs remains a limiting factor, with long waiting lists in some cases.
Transplantation is a fairly established area and new investment tends to be focused around improvements to existing knowledge or capabilities, as well as patient awareness and medical education. Novartis is actively supporting good practice with a number of initiatives including:
Supporting educational meetings which might otherwise not occur as they are often not considered a clinical priority.
Supporting a specialised ‘Academy’ comprising 55 senior professionals in the transplant area, aiming to share best practice and spread knowledge.
Creating educational materials for patients that aim to help them understand treatment options and improve outcomes.
Creating materials to help educate and encourage potential organ donors from the public.
Supporting organ donation awareness programmes to enable the UK to match world-class performance in organ donation and transplantation.