How the implementation of a breathlessness pathway can potentially deliver benefits for our health system, and for the patients we serve.

MSD in the UK have developed the infographic, Counting the Cost: The Hidden Burden of Late Pulmonary Arterial Hypertension Diagnosis, to visualise the potential impact a late diagnosis of pulmonary arterial hypertension (PAH) – a subset of pulmonary hypertension (PH) – has on our health system and the potential cost-savings that could be realised by its earlier diagnosis.

Unexplained breathlessness presents a significant challenge within our healthcare system, often leading to delayed diagnoses of respiratory conditions due to poor symptom recognition and underutilised diagnostic pathways.^[1] Breathlessness is a primary symptom of PAH, and delays in diagnosis not only worsen outcomes and limit treatment options for patients^[2] but also generate considerable costs to the NHS.^[3]

MSD commissioned an independent health economics consultancy to analyse publicly available data on the typical number of GP, hospital appointments and diagnostic tests someone with PAH may undertake before being diagnosed, and the estimated cost of them to the NHS, to estimate the potential savings which could be made if these were reduced.

The research and subsequent infographic support the recommendations from a previous MSD developed piece of work, “A shared vision for pulmonary arterial hypertension in the UK”, to; maximise the opportunity of Community Diagnostic Centres (CDCs) to support the diagnosis of the cause of breathlessness, and, timely referral to an appropriate clinical pathway.

As a rare and debilitating condition that has significant personal impact^[4],[5] implementing a diagnostic pathway which optimises local services to diagnose the cause of unexplained breathlessness can not only improve care for PAH patients but has the potential to deliver system wide benefits for other respiratory conditions, as well.

This infographic and the analysis from which it was created have been fully funded by MSD.

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[1] NHS England. Adult breathlessness pathway (pre-diagnosis): diagnostic pathway support tool. Available at: https://www.england.nhs.uk/long-read/adult-breathlessness-pathway-pre-diagnosis-diagnostic-pathway-support-tool/#purpose-of-this-support-tool [Accessed April 2025]

[2] Kubota K, Miyanaga S, Akao M et al. (2023). Association of delayed diagnosis of pulmonary arterial hypertension with its prognosis. Journal of Cardiology. DOI: 10.1016/j.cc.2023.08.004

[3] Exposto F, Hermans R, Nordgren Å et al. (2021). Burden of pulmonary arterial hypertension in England: retrospective HES database analysis. Ther Adv Respir Dis. DOI: 10.1177/1753466621995040

[4] British Heart Foundation. Research into pulmonary arterial hypertension. Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/research/pulmonary-arterial-hypertension [Accessed April 2025]

[5] PHA UK (2019). Beneath the surface: the true financial impact of pulmonary hypertension. Available at: https://www.phauk.org/about-ph-2/living-with-pulmonary-hypertension/benefits-and-financial-help/the-true-financial-impact-of-ph-survey-results/  [Accessed April 2025]

GB-NON-11235 | May 2025

At MSD we are not afraid to make bold investments in external science where we believe we can further our mission to save and improve lives.

Consider partnering with us…

We know that collaborations are critical to advancing bold science.  Our robust pipeline and portfolio are fuelled by both our own discoveries and external innovation. We leverage our company’s strengths, including our global capabilities from discovery research through commercialisation, to work with our partners to bring new and life-changing therapies to patients.

Our Business Development and Licensing (BD&L) team are focused on identifying breakthrough science and collaborating together to make the greatest difference for patients, now and in the future.

Where are we located?

We’re open to collaboration anywhere the science leads us. Our team of business development and licensing colleagues are co-located within our research & development sites in Boston, South San Francisco and London — epicentres of scientific innovation.

We are searching the world for cutting-edge science regardless of therapeutic area or modality. To find out more about our areas of focus, recent acquisitions and collaborations read more on our global website here or get in touch via the collaborate link.

We share your urgency to transform health care for patients and will act decisively when there’s an opportunity to make a meaningful impact on patients’ lives.

GB-NON-10791 | January 2025

MSD has teamed up with health technology company Axana, and 12 lung cancer clinicians from across Europe to develop a new digital solution to speed up lung cancer care.

The ‘NextGen MDT’ programme aims to help clinicians to make cancer care more efficient and, ultimately, improve patient outcomes.

Lung cancer care has become increasingly complex¹, with numerous tests which must be completed before clinicians can diagnose and treat patients,² and many treatment options available.¹ However, these tests can be difficult to coordinate² and involve different hospital departments or NHS services.³

Clincians specialising in lung cancer gather weekly in multidisciplinary team (MDT) meetings to review each patient’s case and dicuss treatment options.⁴ If clinicians don’t have all of the information that they need prior to the MDT meeting, treatment decisions can be delayed, which can have a negative impact on patient outcomes.⁴

At MSD, we’re determined to tackle this problem.  We know that, when it comes to cancer, time is of the essence.

The NextGen MDT programme will strive to give clinicians the time and information that they need to care for their patients. Through the use of intelligent software, the programme aims to integrate patient information into one unified dashboard – simplifying the process of connecting different hospital information systems so that all of the necessary insights about a patient’s cancer are in one place, enabling clinicians to make treatment decisions at the MDT meeting.

Our ultimate goal is to improve the lung cancer patient pathway – reducing the workload of clinicians while speeding up patient access to timely, optimal treatment.

Professor Neal Navani, Respiratory Medicine Consultant and Clinical Lead for Lung Cancer Services at University College London Hospitals NHS Foundation Trust supported the development of the NextGen MDT programme. Commenting on the project, he said:

“This ambitious NextGen MDT project will help to streamline and improve our cancer MDT discussions, allowing us to make better decisions which will benefit our patients and healthcare systems.”

Rachel Houlding, National Oncology Healthcare Director at MSD UK, said:

“Early diagnosis and treatment of lung cancer is crucial to improving patient outcomes.⁵ Making the patient pathway more efficient is one way to helping patients get the right care for them, sooner – and we believe there is a crucial role that technology can play to achieve this. We are delighted to be working alongside Axana and clinicians across Europe develop such a solution, and look forward to entering the next phase of activity in 2025.”

Jeroen van Duffelen, CEO of Axana, said:

“At Axana, we harness the best minds in data integration and artificial intelligence to address critical challenges in oncology. Our goals are twofold: to enhance clinician efficiency and to expedite patient treatments. Our software streamlines patient data collection and coordination of multidisciplinary team meetings facilitating efficient decision-making by clinical teams. We anticipate that our software will optimize lung cancer care pathways, potentially leading to improved patient outcomes.”

For more information about the NextGen MDT project, please contact corporateaffairsuk@msd.com. 

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[1] Morabito A, Mercadante E, Muto P, Manzo A, Palumbo G, Sforza V, et al. Improving the quality of patient care in lung cancer: key factors for successful multidisciplinary team working. Explor Target Antitumor Ther. 2024;5:260–77. https://doi.org/10.37349/etat.2024.00217

[2] UK Lung Cancer Coalition (November 2023). Scottish Pathways Matter. Available from: https://www.uklcc.org.uk/sites/default/files/2023-10/Final%20UKLCC%20Scottish%20Pathways%20Matter%20report_Nov%202023.pdf

[3] NHS England. Diagnosis: Lung cancer. Available from: https://www.nhs.uk/conditions/lung-cancer/diagnosis/ [Accessed: September 2024]

[4] Cancer Research UK. Meeting Patient’s Needs: Improving the effectiveness of Multidisciplinary Team meetings in cancer services. 2020. Available from: https://www.cancerresearchuk.org/sites/default/files/full_report_meeting_patients_needs_improving_the_effectiveness_of_multidisciplinary_team_meetings_.pdf

[5] Cancer Research UK. Why is early diagnosis important? 2023. Available from: https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/why-is-early-diagnosis-important/1000#:~:text=Around%206%20in%2010%20people,at%20the%20most%20advanced%20stage.

GB-NON-10247 | November 2024

What can we do, working as partners, to improve the lives of people with pulmonary arterial hypertension?

MSD in the UK have published a policy consensus statement, A Shared Vision for Pulmonary Arterial Hypertension in the UK, with recommendations driven by expert insights outlining a unified vision for the future of pulmonary arterial hypertension (PAH) care in the UK.

PAH is a rare subtype of pulmonary hypertension.^[i] The time to diagnosis within pulmonary hypertension remains a persistent challenge. In a recent patient survey, 51% of respondents reported waiting more than a year for their diagnosis of pulmonary hypertension after first noticing symptoms. For a quarter of respondents, this wait took longer than three years.^[ii]

Created with input from the Pulmonary Hypertension Association UK, and specialist experts from across the UK, this Consensus Statement provides policy and systems recommendations aimed at reducing the time to diagnosis as a route to improve patient outcomes and deliver savings to the health system.

PAH is a rare and debilitating condition that has significant personal impact.^[iii],[iv] It also cost the NHS in England an estimated £43.2 million between 2013 and 2017 through repeat appointments and hospital care^[v] and has a broader impact on the UK economy through loss of workforce productivity.^[iii]

The insights and initiatives held within this Consensus Statement reflect the broad challenges in rare diseases. There is no ‘silver bullet’ which could solve all issues, but 16 recommendations across 8 stakeholder groups, which if implemented have the potential to transform PAH care in the UK.

This Consensus Statement and the activities which formed its development were funded by MSD. We thank all who have contributed and have endorsed its recommendations.

Dr Iain Armstrong, Chair, Pulmonary Hypertension Association UK & Nurse Consultant, Sheffield Teaching Hospitals, said:

“PAH carries a huge burden of symptoms and too many people are still waiting too long to be diagnosed. The impact of this delay is wide-ranging, but ultimately, it’s devastating for those individuals – and they deserve better. This consensus statement sheds light on the problem, and we hope it will help drive the change that is so badly needed.” 

Professor Jay Suntharalingam, Consultant Respiratory Physician, Royal United Hospitals Bath, said:

“Although rare, Pulmonary Hypertension can be treated – often though patients are diagnosed late or not at all. This report offers a number of practical ways to address this, potentially allowing more people to receive potentially lifesaving interventions, now and in the future.”

Jasveen Chugh, Pharmaceuticals Business Unit Director, MSD UK, said:

“Too often, people are waiting too long before they receive an accurate PAH diagnosis, and their care can start. Once patients are diagnosed NHS care is commendable. Delays in diagnosis are multi-faceted, including increased costs to the health service, and most importantly negatively impacting patient quality of life and outcomes. The insights and recommendations from experts within this Consensus Statement deliver tangible ways different stakeholders can work individually and together, to reduce the time to diagnosis for PAH patients.”

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[i] N. Galiè, M. Palazzini, A. Manes (2010). Pulmonary hypertension and pulmonary arterial hypertension: a clarification is needed. European Respiratory Journal 36: 986-990; DOI: 10.1183/09031936.00038410

[ii] PHA UK (2023) Breathless, not voiceless: What it means to live with PH today. Available at: https://www.phauk.org/research/pha-uk-led-research/breathless-not-voiceless-what-it-means-to-live-with-ph-today/ [Accessed August 2024]

[iii] British Heart Foundation. Research into pulmonary arterial hypertension. Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/research/pulmonary-arterial-hypertension [Accessed August 2024]

[iv] PHA UK (2019). Beneath the surface: the true financial impact of pulmonary hypertension. Available at: https://www.phauk.org/living-with-pulmonary-hypertension/benefits-and-financial-help/the-true-financial-impact-of-ph-survey-results/ [Accessed August 2024]

[v] Exposto F, Hermans R, Nordgren Å et al. (2021). Burden of pulmonary arterial hypertension in England: retrospective HES database analysis. Ther Adv Respir Dis. DOI: 10.1177/1753466621995040. Available at: Burden of pulmonary arterial hypertension in England: retrospective HES database analysis – PMC (nih.gov)

GB-NON-09962 | September 2024

We have officially opened our interim laboratory facility housed in the roof space of The Francis Crick Institute, marking an exciting milestone in the growth of our discovery presence in London, and our ongoing collaboration with this world-renowned research centre.  

George Addona, Senior Vice President of MSD Research Labs, and Sir Paul Nurse, CEO of The Francis Crick Institute, welcomed Lord Vallance KCB FRS FMedSci FRCP HonFREng, Minister of State for Science, at the opening ceremony held on 5^th September. Together, we celebrated our collective drive towards groundbreaking discovery science that advances human health. 

Located at the heart of London’s Knowledge Quarter, this is the latest addition to MSD’s integrated global R&D network, that is dedicated to seeking solutions to some of the most complex health challenges faced by patients around the world.   

This latest location will foster an effective partnership between our scientists and their counterparts at the Crick, working side-by-side towards the common goal of scientific innovation. The space is leased for an initial period of 3 years in preparation for the 2027 opening of our new MSD Research Laboratories, London and UK Headquarters, in Kings Cross.  

The opening of SkyLab, with the central London location offering valuable proximity to the capital’s Knowledge Quarter, builds on MSD’s 100-year heritage in the UK. The new facility will accommodate approximately 50 MSD researchers, who join MSD’s rapidly expanding interdisciplinary London-based team of over 100 scientists with expertise spanning chemistry, pharmacology, neuroscience, and immunology, to unlock new frontiers in early-stage drug discovery. 

MSD’s commitment to operating responsibly is evident in the design and construction of this 11,800 sqft facility, which adheres to the highest sustainability standards. Ensuring environmental stewardship is at the heart of MSD’s wider R&D presence reflects our mission for a safe and healthy future for people and communities. 

These developments represent another addition to our discovery capabilities as we continue to expand our R&D footprint in the UK and Europe, in anticipation of the opening of our new London home in 2027. 

Lord Vallance, Minister of State for Science, Research and Innovation, commented:

“The opening of Skylab represents a fantastic opportunity to advance UK science and is a vote of confidence in the UK as an investment destination”

George Addona, Senior Vice President and Head of Discovery, Preclinical and Translational Medicine, MSD Research Laboratories, commented:  

“Our talented team of London-based discovery scientists are an integral part of MSD’s global research network, and we are pleased to expand our research presence in London’s Knowledge Quarter.”

GB-NON-10053 | September 2024