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Health leaders reveal ten most important medicines in NHS history

Health experts in the UK have identified what they believe to be the ten most important and impactful medicines and vaccines introduced in to the NHS in the past 70 years.

Among the top ten are two vaccines – those which prevent polio and measles, mumps and rubella – as well as medicines which have transformed HIV/AIDS from a death sentence to a manageable condition, immunosuppressants which paved the way for successful transplants, and antipsychotics that led the way for all modern treatment of mental health conditions including depression, schizophrenia and bipolar disorder.

The findings are published in a new report from OHE Consulting Ltd and commissioned by the Association of the British Pharmaceutical Industry (ABPI). The report celebrates the contribution of medicines and vaccines to the NHS in the year the NHS turns 70.

The report demonstrates through interviews with several leading health experts1, including pharmacists, clinicians and scientists, the contribution and impact of medicines based on health and economic outcomes and impact on the healthcare environment. The medicines were chosen from a long list of 37.

The top ten medicines and vaccines are:

Chlorpromazine (Year of launch: 1953)

Chlorpromazine was the first antipsychotic, synthesised in 1951 and first used in the NHS in 1954. It is seen as fundamental in the ‘psychopharmacological revolution’ and paved the way for deinstitutionalisation and community-based care for people with mental illness. It gave rise to all modern antipsychotic and antidepressant medications and is still included in the WHO Model List of Essential Medicines.

Polio vaccine (Year of launch: 1955)

Responsible for eradicating polio in the UK within 11 years of its introduction and predicted to have saved 10,000 lives between 1958 and 2018.

Oral contraceptives (Year of launch: 1961)

‘The pill’ was one of the first medicinal products to be taken daily by millions of healthy people, creating new dynamics in the consideration of the risks and benefits of pharmaceutical products.

Oral contraception was identified by interviewees as having had an important health, economic, and broader social impact in the UK. It has been described as the medical development with perhaps the greatest ‘non-medical’ consequences.

Second to fourth generation penicillins (Year of launch: 1961)

Despite current concerns about antimicrobial resistance and overuse of antibacterial agents, antibiotics are regularly cited as one of the most important developments in the history of medicine.

Beta Blocker (Year of launch: 1965)

Used to treat heart disease, there is strong evidence that patients receiving beta blockers experience a relative risk reduction in mortality of around 35%, with an absolute difference in death rates of around 5%.

Beta2 agonists (Year of launch: 1969)

In the UK in the mid-1960s, three in every 100,000 people aged 15-44 died because of asthma. A decade later, that rate had fallen below one per 300,000. The shift can be attributed in large part to anti-asthma agents like Beta2 agonists.

Tamoxifen (Year of launch: 1972)

Breast cancer care has undergone major changes over the history of the NHS, including surgery, radiotherapy, hormonal and cytotoxic treatment, and screening by mammography. First available in the UK in 1972, tamoxifen was cited by some interviewees as a key development in breast cancer care with major health impact.

The availability of the medicine was part of the justification for the introduction of a national screening programme in 1988, after which breast cancer mortality rates declined significantly.

Immunosuppressants (Year of launch: 1972)

Immunosuppressive medications facilitated successful organ transplant in the 1960s. A breakthrough for modern transplant surgery happened in 1983 with the introduction of cyclosporin.

The first successful heart-lung transplant in the UK was conducted in 1983; 1985 saw Britain’s youngest liver transplant patient; and in 1986 the world’s first liver, heart and lung transplant was successfully completed in Cambridge. Immunosuppressants were cited by interviewees as significantly reducing the burden on the NHS through reducing the rate of transplant rejection.

HIV/AIDS antiretrovirals

Zidovudine was the first treatment for human immunodeficiency virus (HIV). Interviewees pointed to zidovudine and other antiretroviral treatments for HIV as having prevented an acquired immune deficiency syndrome (AIDS) pandemic that could have overwhelmed the NHS.

Subsequent developments in the treatment of HIV, including combined antiretroviral therapy (cART), have achieved major gains in morbidity and mortality. cART has been shown to reduce mortality by 50%.

MMR vaccine

In 1948, there were almost 400,000 cases of measles in the UK, and 327 people died. In 1968, a measles vaccine was introduced, and the number of cases and deaths fell dramatically. 1994 was the first year without a measles death. By 2015 the number of cases of measles in the UK stood at 1,200.

The long list of 37 medicines can be found here.

Speaking about the research, Dr Sheuli Porkess, Deputy Scientific Officer at the ABPI, said:

“The discovery of ground-breaking medicines and their introduction in to the NHS had been transformational for patients. For 70 years, our industry – working alongside the NHS – has seen life-threatening diseases cured or become manageable conditions, including cancers, heart disease and HIV.

“In 70 years-time I hope we will be celebrating how advances in exciting new research in genetics, artificial intelligence and personalised medicines have helped to cure and treat many more complex diseases.”

Report author, Paula Lorgelly, said:

“The milestone of the NHS turning 70 provides an opportunity for us to consider the impact of medicines to the success of the NHS. “As well as identifying a short list of influential and often overlooked medicines, we also identified factors that aided their impact. These included the value of innovation, complementarity and scientific spillovers, substitution, the evidence base, aiding understanding, active collaboration and supportive health policy. These factors are important to consider to ensure new and future medicine developments continue to deliver impact to the NHS.”

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