Science, Innovation and Technology Committee inquiry:
Life Sciences Investment
- Glaukos Corporation is an ophthalmic medical technology innovator focused on the development and commercialisation of breakthrough products and procedures designed to transform the treatment of glaucoma. We have pioneered Trabecular Micro Bypass Glaucoma Surgery (MIGS) and we lead the global glaucoma market with our iStent inject® that advances the existing glaucoma standard of care worldwide.
- We welcome the opportunity to respond to this inquiry and will focus our response on the steps needed to support the widespread adoption of medical technologies (medtech), with a particular emphasis on the ophthalmology sector, to help solidify the UK’s position as a global leader in life sciences.
- The UK’s life sciences sector possesses significant strengths, such as a large ecosystem of biotech and medtech companies, a robust research and scientific infrastructure, a strong Government commitment to R&D, and a well-established regulatory framework.
- However, the sector’s international competitiveness is frequently challenged by continued barriers that limit both the pace and scale of investment and adoption of innovation, particularly in the medtech sector.
- Government strategies, such as the Life Sciences Sector Plan, have set a positive direction for boosting the medtech sector in the UK. Yet their impact has been hindered by slow regulatory approval processes, complex reimbursement pathways, and fragmented commissioning routes. For medtech companies like Glaukos, these barriers have a direct impact on patient access to and the commercial viability of innovative medical devices and technologies.
- The adoption of medtech delivers significant benefits for both the NHS and the wider life sciences sector:
- For the health system, innovative diagnostics, devices and digital tools enable faster diagnosis and quicker patient recovery. This helps to reduce waiting lists, improve patient outcomes, and support the sustainability of the health system, which in turn eases the long-term pressure on NHS resources.
- For the wider life sciences sector, embracing medtech helps to stimulate economic growth by attracting investment, driving innovation, and creating high-value jobs across the UK, strengthening the UK’s position as a global leader in life sciences.
- As outlined in a recent consensus document from the UK and Eire Glaucoma Society[1] innovative MIGS devices, such as Glaukos’ iStent inject®, offer multiple benefits for patient safety, as well as preventing the imposition of large costs on the health and social care systems:
- They help to prevent avoidable sight loss by stopping the progression of glaucoma.
- They reduce reliance on conventional eye drop glaucoma treatments (the effectiveness of which is often hindered by low patient adherence).
- They optimise healthcare resources and capacity through early intervention by removing the need for secondary invasive surgery, reducing the requirement for ongoing follow-up appointments, and reducing the burden of long-term treatment.
- However, despite NICE approval for iStent inject® as well as these significant patient and system benefits, Glaukos has achieved only 20% market penetration in the UK, which falls below what could be capable in comparison to other markets. The slow uptake of innovation, for both Glaukos and other similar medtech innovators, is driven by several challenges:
- Even after a technology receives NICE approval, individual commissioning teams at local and regional levels require separate regulatory evaluations, which results in significant delays to adoption and unequal patient access.
- These fragmented commissioning routes are compounded by varied adoption across different health providers, such as in NHS-contracted independent sector treatment centres (ISTCs), where differences in procurement policies and clinical practice can mean that innovative treatments are available in some areas but not in others.
- This lack of standardised, coordinated pathways for integrating medtech into routine care can limit the NHS’s ability to benefit from the latest technological advances, which can result in reduced investment in the UK market.
- To enhance competitiveness, we urge the Government to prioritise faster regulatory approval processes, improve the alignment between NICE evaluations and NHS commissioning, and provide greater incentives for the faster adoption of proven innovations. Ensuring continued support of R&D, clearer funding routes for medtech, consistent national implementations of technologies will also help attract greater investment in the UK life sciences sector.
- Recent US policy changes, such as the introduction of potential tariffs and the consideration of the ‘Most Favoured Nation’ pricing principle for pharmaceuticals, have created significant uncertainty for global life sciences companies, including those in the UK.
- These changes could potentially divert global R&D and launch priorities away from markets with more restricting pricing criteria or unpredictable routes to reimbursement and commissioning. This is also applicable to the UK, which risks being deprioritised for investment or manufacturing from global medtech companies if it is viewed as a less attractive launch market compared to other countries.
- This is particularly relevant for companies manufacturing medtech and innovative devices, where wide adoption and rapid uptake is critical for continued investment. Ensuring that the UK remains a competitive destination for innovation requires an active monitoring of global policy shifts from the Government, as well as a commitment to ensure the maintenance of attractive investment and market access conditions.
- The UK’s approach to pricing and uptake, especially through the NICE quality-adjusted life years (QALY) assessment, has historically fostered an evidence-driven environment. However, this methodology has the potential to undervalue preventative and medtech innovations, such as ophthalmic technologies, that can deliver long-term benefits, such as improving patient care, reducing burden on health services, and improving productivity, which may not be fully captured by traditional QALY assessments.
- The UK’s pricing and uptake criteria can often lag behind leading European markets. The limited adoption of Glaukos’ iStent inject® has been in part due to the challenges in translating NICE approval into routine commissioning and reimbursement, particularly across devolved nations and ISTCs.
- We urge the Government to address NICE processes to ensure that they are refined and updated to better account for the full spectrum of value delivered by medtech, including improved patient quality of life, reducing reliance on long-term medications, and system-wide cost savings.
- The NHS plays a pivotal role in determining the real-world impact of innovation in life sciences. While both MHRA and NICE have taken steps to evolve their approaches, such as the recent announcement that NICE will be applying the same standards for assessing new medicines to evaluate medical devices, diagnostics and digital tools[2],the implementation of innovation at scale still remains a challenge.
- The primary factor of this is the lack of consistent adoption pathways for medtech innovations. Despite a device having regulatory approval, variable commissioning and reimbursement routes continue to create barriers to widespread patient access.
- We call on the NHS to accelerate the adoption of proven technologies by streamlining funding and commissioning routes, ensuring that innovative technologies and solutions are accessible to all types of health providers, and embedding combined procedures into standard glaucoma care pathways.
- The following recommendations can help the Government address regulatory, reimbursement and commissioning barriers to improve the spread of medtech innovation across the UK’s life sciences sector.
Streamline commissioning and reimbursement routes
- Developing clear and more consistent national funding and commissioning pathways to accelerate the adoption of NICE-approved technologies, will help to ensure equal and efficient access to medtech across all regions and providers, including NHS-contracted ISTCs.
Enhance medtech investment
- Sustained investment in medtech that enables innovative and effective care delivery should be prioritised. The adoption of proven solutions, such as MIGS devices, can significantly reduce the burden on NHS services, improve waiting lists and enhance patient safety and care.
- Prioritising investment in medtech, such as through targeted incentives, will also enable the NHS to deliver more advanced treatments, which ensures the NHS remains at the forefront of clinical best practice, and delivers long-term cost savings.
Support consistent national implementation
- Fostering national consistency in the adoption of innovation can help to reduce variation and fragmentation across regions, devolved administration and different health providers, helping to reduce health inequalities.
13 October 2025