Opinion
Positively disruptive: the top five trends dramatically altering the UK pharma market access space
By Brenda Dooley, founder and CEO of AXIS Consulting UK and Ireland

For virtually every industry in the world, the last several years have been, in a word, tumultuous.
Every industry, from hospitality to manufacturing, has been impacted by global events such as Brexit, the COVID pandemic, the Ukraine crisis and economic strife.
The pharmaceutical sector has been no different, but not all change is negative. In fact, the pharmaceutical market access industry in the UK is experiencing a whirlwind metamorphosis that is likely to echo in some interesting trends as we move towards 2024.
As the winds of change unearth new opportunities, disrupting traditional models, the industry as a whole looks set to witness a dramatic shift in the pharma market access space.
Uncertainty and opportunity
Uncertainty can create a sense of unease in an industry. Intrinsically, it is human nature to find comfort and reassurance in what we know, so when significant events, such as Brexit, impact our lives, professionally and personally, it can be difficult to see the wood for the trees.
With the future so unclear, making the best business decisions can sometimes be extraordinarily difficult, but there is something to be said for how empowering it can feel to focus on your goals and emerge from the chaos, with a stronger business sense.
With the UK’s departure from the EU creating waves of uncertainty throughout the world, there is also opportunity to find clarity and move steadily forward. For the pharmaceutical market access industry, it is a chance to explore regulatory flexibility and reshape the NHS.
Additionally, creative, intelligent strategies within the market access sphere will help the sector to adapt to the ever-changing landscape.
In this new era for the UK, it is crucial that the region maintains its attractiveness and stays on track, or indeed ahead, of the European Medicines Agency (EMA) for drug licensing. For example, the UK must focus on continuing to gain investment from manufacturers headquartered in the US.
The Medicines and Healthcare Products Regulatory Agency (MHRA) will launch its new international recognition framework on January 1, 2024, to ensure continued alignment with the EU as well as further trusted partners, so transparency and collaboration will be paramount.
Global digitalisation
Mass digitisation is a trend that is unlikely to slow down anytime soon. Moreover, the majority of industries worldwide, especially those wishing to successfully navigate uncertain times, will have to adopt modernisation methods to stay afloat and relevant.
This is also true of the UK pharmaceutical market access sector. As we go into 2024, we are likely to see different divisions of the pharmaceutical industry utilising innovative AI technologies.
Positively disruptive advancements such as virtual clinic trials, and machine learning algorithms and data, will have the potential to reduce costs, optimise on efficiency, and improve the overall patient experience, which is always at the core of the industry.
Pharmaceutical market access in the UK – and indeed throughout the world – is a highly interconnected sector that thrives on collaboration. Mass digitalisation further bonds the organisations that operate within that sphere and it is important that we fully understand the technology that will ultimately dictate the future of market access, making it more accessible for all.
HTA agency collaborations
The role of Health Technology Assessments (HTAs) is crucial in the goal of making a drug reimbursable and accessible through state organisations such as the NHS. Now, more than ever, HTAs influence who can access certain medications, as well as the impact of the financial cost.
An inability to prove a drug’s value and cost-efficiency can seriously impact the likelihood of a successful submission, therefore, as we move towards another new year in a few short months, more and more businesses will be prioritising partnerships and information sharing channels, with the aim of streamlining and successfully traversing the HTA process.
A deal brokered between the UK, Canada, New Zealand and Australia will see the topic of global HTA collaboration remain at the forefront of the conversation and has already begun identifying the main areas of interest to the eight partner agencies for 2023-24. Partners will explore the feasibility of work sharing to support HTA decision making and expand their capacity.
Activities will include the identification of methodological and procedural areas where further HTA alignment is needed to support future work sharing, engagement with national and global stakeholders regarding opportunities for work sharing, initial process development, and pilot identification and for non-pharmaceutical technologies, a process to share information about planned and in-progress assessments.
Patient-first discourse
Long-gone are the days where people take a passive role in their health, signing over autonomy to a trusted GP, pharmacist or government body.
These days, the individual is instrumental in the decision making process, and is often highly informed as to the various organisations and policies dictating their health and future wellbeing.
In part, this has led to pharmaceutical companies placing the individual at the centre of their own policy making, promoting the prioritisation of patient-centric therapies and pricing models.
Innovative payment models
The UK is showing signs of adopting a more progressive mindset than many other jurisdictions, and this is a pattern that will need to continue if the region is to remain attractive to stakeholders and investors.
A recent report describes the NHS as “the first health system in the world to put in place a national, targeted programme for a high-risk group of people with Type 2 Diabetes Mellitus.” Around 140,000 people aged 18-39 will receive additional tailored health checks and support with diabetes management, such as blood sugar level control, weight management and cardiovascular risk minimisation.
Funding of £14.5m will enable local health teams to roll out the new scheme to “help minimise the risk of these people developing health complications and severe illness and to support a reduction in health inequalities.”
Innovative payment models could help the NHS manage long-term uncertainty and help to address cumulative NHS affordability challenges, for example in cell and gene therapies.
Ultimately, before we know it, 2024 will be upon us. Though we will likely face many of the challenges experienced in the previous 12 months, we can also expect some positively disruptive trends to dramatically alter the UK pharmaceutical market access sector.
Brenda Dooley is founder and CEO of AXIS Consulting UK and Ireland. AXIS Consulting provides strategic market access and health technology assessments for pharmaceutical and biotechnology firms.
News
We built Ema like a nurse: Here’s why that matters

By Claire Pettengill, science intern and Jade Anstine, clinical AI intern, Ema EQ
Every year, Gallup asks Americans which professions they trust most. Every year, nurses win. Not doctors. Not scientists. Nurses. And if you spend any time thinking about why, the answer is not hard to find.
Medicine runs on the nurse noticing first. In other words, the diagnosis follows the nurse sounding the alarm. They ask questions that feel human, not procedural. They explain what is happening in language you can understand.
And, critically, they know when something is beyond their scope and get you to the right person without making you feel like a burden for needing more.
That is the model we built Ema on.
When we set out to build an AI companion for women’s health, we could have just built something that answers questions efficiently. Pattern matching. Fast retrieval. Clinically accurate outputs.
Those things matter, and Ema does all of them. But accuracy alone does not build trust, and trust is the entire game in healthcare.
A woman asking about her postpartum recovery, her fertility, or her breastfeeding supply is not looking for a search engine. She is looking for someone who will take her seriously.
Women’s concerns don’t just need to be ‘validated’; they also need to be believed. Dismiss a woman’s pain as anxiety once, and you’ve taught her to doubt her own body.
The nursing model of care is built on exactly that premise. It is care that is shaped by her story. It asks about context and symptoms.
It treats the person as a whole, and it recognises that the right answer is sometimes a referral, not a response.
We trained Ema to escalate. That may sound like a small thing, but in AI, it is a deliberate design choice.
Most AI systems are optimised to answer and maintain engagement. Ema is optimised to help, and sometimes helping means saying “you need to speak to a clinician” and making that path easy.
This matters especially in women’s health, where the clinical trust gap is well-documented.
In a 2022 nationally representative survey of over 5,000 women, nearly 1 in 3 reported that their doctor had dismissed their concerns, and 15 per cent said a provider simply didn’t believe them.
Women are more likely to have their symptoms dismissed, their concerns minimised, and their pain undertreated. Among women under 35, nearly half reported at least one of these experiences.
They have had to learn how to advocate within systems designed for efficiency, built on men’s health.
With Ema, every conversation is an opportunity to make a woman feel heard, informed, and directed to the right level of care, neither over-triaged nor undertreated.
The goal is not to replace clinicians. It is to create a trustworthy first point of support that listens carefully, explains clearly, recognises limits, and helps women move toward appropriate care.
The nurses who top those Gallup rankings every year earn that trust through consistency. They show up, listen, follow through, and know their limits.
Ema is simply that trust, built into technology. That is the standard we hold Ema to: a trustworthy presence that knows when to answer and when to hand off.
Medicine spent a long time teaching women not to expect to be believed. Ema is built by the people who never stopped listening.
Bios
Claire Pettengill is a psychiatric nurse and DNP-PMHNP candidate at Columbia University School of Nursing, specialising in women’s mental health across the lifespan and algorithmic justice – ensuring the AI tools shaping women’s care are built to actually listen. She joined Ema EQ as a science intern focusing on clinical safety standards for evaluating AI in women’s health.
Jade Anstine is a senior nursing student at Gustavus Adolphus College looking to bridge the gap between frontline medicine and digital health innovation. He joined Ema EQ as a Clinical AI Intern to assess the Ema AI model across different clinical populations, specifically pediatrics and LGBTQ+.
Opinion
The technology exists: Why are women still waiting?

By Jane Lewis, chief operating officer, chief financial officer and women’s health lead, ABHI
For years, the conversation around women’s health has rightly focused on recognition.
Recognition that women wait longer for diagnosis. Recognition that symptoms are too often dismissed or normalised. Recognition that healthcare systems have historically been designed around male biology, leaving gaps in research, evidence and care.
That recognition matters. But awareness alone will not improve outcomes.
The challenge facing women’s health today is no longer simply identifying the problem. It is acting on the solutions already available.
At ABHI’s Women’s Health Summit earlier this year, leaders from across healthcare, government, academia and industry came together to discuss the future of women’s health.
One message emerged repeatedly throughout the day: we do not have an innovation problem.
Across medical devices, diagnostics, digital health and genomics, there are already technologies capable of transforming outcomes for women.
From self-sampling approaches for cervical screening and non-invasive diagnostics to AI-enabled tools and advanced imaging, innovation is happening. The question is whether healthcare systems can adopt it quickly enough.
Too often, promising technologies become trapped in pilot programmes, fragmented procurement processes or lengthy implementation pathways. Evidence generation, commissioning and adoption are frequently treated as separate challenges rather than part of a single journey.
The consequence is that innovations capable of improving quality of life and reducing pressure on health services take years to reach the women who could benefit from them.
This matters because women’s health extends far beyond reproductive health.
Historically, many discussions have centred on fertility, pregnancy and gynaecological conditions. These remain critically important, but they represent only part of the picture.
Women experience cardiovascular disease differently to men. They are disproportionately affected by autoimmune conditions. They face distinct health challenges throughout their lives, from adolescence to healthy ageing.

Jane Lewis
Yet healthcare systems often continue to approach these issues in isolation.
A woman does not experience her health in separate compartments. Pregnancy, cardiovascular risk, menopause, mental health and musculoskeletal conditions are interconnected.
Healthcare systems need to reflect that reality through more integrated, life-course approaches to care.
There has never been a better opportunity to do so.
Across the NHS, the shift towards prevention, community-based care and digital transformation aligns closely with the needs of women’s health.
Women’s Health Hubs are already demonstrating the benefits of bringing services together around the needs of women rather than organisational boundaries. Digital technologies are helping to identify risk earlier and support more personalised care.
Innovation can help deliver all three of the NHS’s major transformation ambitions: moving from treatment to prevention, from hospital to community, and from analogue to digital care.
But innovation alone is not enough.
Closing the women’s health gap also requires us to address longstanding gaps in research and evidence.
Women remain underrepresented in many areas of clinical research, and sex-disaggregated analysis is not always applied consistently. The result is that clinical pathways and treatment decisions are often based on evidence that does not fully reflect female physiology.
Better data, stronger research participation and greater focus on female-specific and female-predominant conditions will be essential.
There is also a compelling economic case for action.
Women’s health is often framed as an equality issue, and equality remains central. But poor health affects workforce participation, productivity and economic growth.
Improving outcomes for women benefits not only patients, but employers, healthcare systems and wider society.
Yet despite this, women’s health innovation continues to attract only a fraction of the investment directed towards other areas of healthcare.
That is beginning to change.
Across the UK and internationally, momentum is building. Governments, investors, researchers and innovators increasingly recognise that women’s health is both a societal necessity and an economic opportunity.
The conversation has moved on significantly in recent years. Topics that were once overlooked are now firmly on the policy agenda.
The next challenge is ensuring that awareness translates into action.
The technologies exist. The evidence is growing. The policy direction is increasingly clear.
ABHI is increasingly taking this agenda beyond national boundaries. Through our engagement with international industry associations, policymakers and healthcare leaders, we are working to ensure that women’s health is recognised as both a health and economic priority.
We are helping to shape discussions on innovation, regulation, investment and adoption, while sharing lessons from the UK with partners around the world.
Whether addressing the gender health gap, improving access to diagnostics or accelerating the uptake of new technologies, international collaboration will be essential.
The challenge now is not recognising the need for change, but delivering it.
Women have waited long enough for acknowledgement of the problem. They should not have to wait any longer for the benefits of the solutions that already exist.
ABHI is the UK’s leading industry association for HealthTech. Its members, ranging from multinationals to small and medium-sized enterprises (SMEs), develop and supply technologies spanning everything from syringes and wound dressings to surgical robots, diagnostics, and digitally enabled healthcare solutions. ABHI’s 400 member companies represent approximately 80% of the UK HealthTech sector by value.
Opinion
Women’s Health has waited long enough for innovation

By Dr Fran Conti-Ramsden, clinician at Guy’s and St Thomas’ NHS Foundation Trust, academic at King’s College London, and chief medical officer of MEGI Health.
A woman gives birth. A few days later she goes home, often with a bag of medication for her blood pressure, and then, very often, very little structured follow-up for her heart (cardiovascular) health.
In my clinical work, and through our collaboration with Action on Pre-eclampsia, I see and hear about this postnatal cliff edge again and again, and it still shocks me.
We invest a lot of medical care and attention whilst a woman or birthing individual is pregnant, then, at the very moment emerging evidence suggests we have a window of opportunity to modify long-term health, the support falls away.
That cliff edge is a symptom of a deeper issue: we have come to treat “women’s health” as a synonym for reproductive health. Pregnancy, periods and fertility, important as they are, have crowded out everything else.
Yet the conditions that do most to shorten and limit women’s lives are not reproductive at all.
Cardiovascular disease is the leading cause of death in women worldwide, and it is still too readily thought of as a man’s problem.
Heart disease in women is more likely to be missed and under-treated, in part because for decades women were under-represented in the research that built our knowledge.
Pregnancy makes this vivid.
Conditions such as pre-eclampsia are not only risks to be managed for nine months; they are early warnings about a woman’s future, markers that she is more likely to develop heart disease and high blood pressure in the years to come.
We have the knowledge to act on that. What we mostly do instead is discharge her and look away.
This is exactly the kind of problem better tools should help us solve: spotting risk earlier, supporting women and their clinicians through the vulnerable postnatal window, and providing continuity where the system currently provides a drop due to lack of capacity.
Artificial intelligence and digital health have real potential here; in risk prediction, in monitoring blood pressure at home, and in helping stretched clinicians know who needs attention and when.
And yet this is not where most of the energy is going.
It is far easier to build, fund and scale an app that tracks a cycle than a tool that changes the trajectory of a woman’s heart.
So, innovation clusters at the lighter, lower-risk end of innovation, while the conditions that actually kill and disable women, and moments like the postnatal cliff, stay under-served.
Closing the women’s health gap could add at least a trillion dollars to the global economy each year, the World Economic Forum estimates, but the bigger prize is women living longer, healthier lives.
None of this means technology is a cure in itself. It is a tool, and a tool built carelessly can do harm.
Because women have been under-represented in medical data, systems trained on that data can quietly carry the same blind spots forward, deepening inequalities rather than closing them.
Responsible innovation, with clinical-grade evidence, privacy and equity designed in from the start, and tools built around real clinical pathways rather than bolted on afterwards, is not a brake on progress.
It is the only version of progress worth having.
I am optimistic, because a serious community is forming around exactly these questions and the appetite to get it right is real.
It is why, at MEGI, we are bringing clinicians, researchers, founders, regulators and investors together for our AI × Women’s Health summit on 25 June.
If we keep our focus on the conditions that matter most to women’s lives, and build the tools to meet them responsibly, the postnatal cliff edge could become something else entirely: the moment the system finally catches her and delivers preventative healthcare.
AI × Women’s Health: Innovation, Challenges and Opportunities summit is taking place on Thursday 25 June 2026 at the London Institute for Healthcare Engineering. The event is free and is fully booked and operating a waiting list. Join the waiting list here.
About Dr Fran Conti-Ramsden
Dr Fran Conti-Ramsden is a UK Obstetrics and Gynaecology registrar and Chadburn Clinical Lecturer at KCL passionate about transforming women’s health through technology and innovation.
Combining NHS clinical experience with an MRC-funded PhD, recent NHS Clinical AI fellowship and commercial role as Chief Medical Officer at Megi health, she works at the intersection of clinical medicine, data science, technology and AI.
Her current programme of research focuses on the intersection of healthcare and technology; leveraging advances such as smartphone based vital signs capture and large language models to drive forward scalable innovation in maternal cardiovascular care.
She has published over 20 peer-reviewed manuscripts (See gScholar, h-index 12), including award-winning work recognized by Hypertension Journal.
She was awarded an AI visionary award in 2025 by Health Innovation KSS was the recipient of the 2024 International Society for the Study of Hypertension in Pregnancy Zuspan prize.
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