Healthcare’s Premier Industry Advisor

NHS dentistry has been significantly impacted in recent years, with the COVID-19 pandemic exacerbating systemic weaknesses. Pre-existing issues including chronic underfunding, workforce issues, and unattractive NHS contracts have collided with pandemic-related disruptions to leave millions of patients waiting for care. With the recent uplift in NHS dental contract falling short of the recommendations from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), the Labour government has failed to alleviate the funding challenges associated with NHS dentistry, and intensified financial pressures on NHS dental providers. As investors look towards the rest of 2025 and beyond, one key question is this: how are these challenges accelerating uptake of private dentistry within the UK dental landscape, and what new investment opportunities may they present in the future? In this paper, Marwood examines the implications of the NHS contract uplift and broader funding constraints, assessing their impact on the competitive landscape of UK dentistry. We explore key market trends, identify potential areas of growth for private providers, and outline strategic considerations for investors seeking to capitalise on emerging trends in dental care.

Penetration of VBC initiatives in Medicaid, particularly those that are risk-based, has historically lagged the more significant growth in VBC within the Medicare Advantage population. However, as Medicaid Managed Care plans and states face cost pressures while aiming to improve outcomes and increase access, there has been an increasing shift away from fee-for-service reimbursement models tied to volume and towards alternative payment models (APMs) that more closely tie reimbursement to outcomes and align incentives by gradually encouraging providers to take on more risk. As a result, there is growing interest among a diverse group of stakeholders including investors, providers, MCOs, and healthcare technology companies in pursuing new revenue opportunities within Medicaid VBC. Programs that effectively realign incentives to prioritize outcomes and value can generate savings for states and MCOs and lead to improvement in the overall quality of care for patients. Herein we address opportunities for VBC for the Medicaid population, identify major challenges facing stakeholders, and examine differences between states that may facilitate greater adoption and success.

Italy is expanding the scope of its Innovative Medicines Fund which will undergo a restructure to now include specific spending ceilings for conditionally innovative medicines and specific antibiotic drugs in 2025, as indicated by the 2025 Budget Law. Alongside this, the Italian Medicines Agency (AIFA) is expected to review the current evaluation criteria for the attribution of innovative status by 31 March 2025, and is likely to include new criteria which are expected to focus on a wider combination of technological and clinical factors that spans the entire pharmaceutical life cycle such as production technology and impact on patients’ lives. This reform presents an important shift for the innovative medicine landscape in Italy by offering ring-fenced funding for specific drug categories and allowing more drugs to be eligible for funding. In this piece, Marwood analyses the changing landscape for innovative pharmaceuticals in Italy and how this may impact investors as well as manufacturers.

Over the last few years, the biotech market has grappled with a global pandemic, numerous drug shortages, burdensome supply chain disruptions, escalating trade tensions, and a difficult funding environment. Underlying these broader issues is the threat to each nation’s biosecurity. Historically, the term has mostly referred to practices that prevent the spread of harmful pathogens, such as disinfection or quarantine. Today, nations have broadened the term to encompass practices that improve the health of their biotech industries. After all, fostering domestic biotech innovation with self-sustaining, high-quality supply chains inarguably does bolster a nation’s biosecurity. On the other hand, enabling a country’s biotech startups to access foreign, low-cost supplies and services also fosters domestic innovation. Providing citizens with expedited access to breakthrough treatments approved in foreign countries also bolsters a nation’s biosecurity. China, as the world’s fastest-growing hub for biotech development, manufacturing, and research services, is now causing western nations to grapple with this delicate balance; some through domestic stimulus and others through punitive restrictions. As the current market leader in biotech innovation, the US seems to favor the latter approach.

The Autumn Budget 2024 is the first budget by a Labour Government in more than a decade. On 30 October 2024, Rachel Reeves, Chancellor of the Exchequer delivered a one-year budget (Phase 1) setting out both an updated 2024/25 spend and planned funding for next year. A longer-term Spending Review will follow in Spring of 2025 (Phase 2). A public audit in July 2024 showed that the new Labour Government inherited a budget deficit with a projected overspend of £22 billion in 2024/25. Therefore, this Budget’s objectives are to keep public spending on a sustainable path, grow day-to-day departmental spending to support public services, and to boost capital investments with a greater focus on value for money and long-term growth. This is a significant event for investors in healthcare and provider entities as it highlights the Labour Party’s priorities and ambitions. In this publication, Marwood provides an overview of key budgetary announcements that affect the health and social care sectors in the UK.