New Perspectives on Access to Medicines

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The COVID-19 pandemic brought the issue of access to medicines to the forefront. Not only did supply chain disruptions lead to initiatives designed to make sure essential medicines reach patients, but the pandemic also served to underline a number of pre-existing access inequalities. Several of PharmaBoardroom’s recent interviewees have discussed their views on access.

 

A huge issue in the United States

According to a 2021 Commonwealth Fund study, “profound racial and ethnic disparities in health and well-being have long been the norm in the United States.” The study pointed out that “the COVID-19 pandemic has only made things worse, with average life expectancies for Black, Latinx/Hispanic, and, in all likelihood, AIAN people falling more sharply compared to white people.”

For the Pharmaceutical Research and Manufacturers of America (PhRMA), the organisation that represents US innovative drug companies, the biopharma industry has always aimed for access and affordability.

“Our focus on access and affordability has multiple dimensions, but the biopharma industry has always worked to ensure that the medicines it makes are broadly accessible to patients,” said Stephen J. Ubl, President & CEO, in a recent PharmaBoardroom interview.

Ubl went on to recognise that: “The COVID experience laid bare many of the inequities plaguing our system … The industry has long worked to address these inequities, but COVID catalysed more focus and energy towards this push.” He said that PhRMA’s members are making an effort to bridge the gaps in the US healthcare system by ensuring that they are diverse and inclusive employers and by improving the diversity of clinical trials.

“An improvement in clinical trial diversity is crucial in rebuilding trust in communities of color that have historically been excluded from data collection efforts and mistreated in trials,” he said.

In a recent PharmaBoardroom interview, Dan Leonard, the President and CEO of the generics and biosimilars lobby group, the Association for Accessible Medicines, said that AAM advocates for access. “We are totally aligned on the fact that patients need more access and more affordability in their medicines.”

However, AAM is not fully in agreement with the Biden administration on how to achieve this. “… we have significant problems with the way that prescription drug legislation is constructed and hope to work with Congress to remedy it. If high prices are the problem, then generics are the solution. But we would go at it in a different way; we encourage a model with more competition. Again, getting to some of these intellectual property issues would also be a way to bring competition to the market sooner so patients could get more affordable medicines sooner,” Leonard said.

 

The European perspective

Characterised by universal healthcare systems, Europe may not be seeing such widespread disparities as in the United States, but within the European Union there is concern about equitable access because typically medicines do not reach member states at the same time.

Nathalie Moll, Director General of the European innovative pharma industry organisation, the European Federation of Pharmaceutical Industries & Associations (EFPIA), also spoke about access in this PharmaBoardroom interview: “ … research by EFPIA showed patients in one European country can wait seven times as long as patients in another EU member state for access to the same medicines. The situation is untenable,” Moll said.

To address the issue, EFPIA members have made a commitment to file for pricing and reimbursement in all EU member states no later than 2 years from the central EU market authorisation.

“According to our estimations, we can bring the availability of medicines up from about 18%, to 64% in several countries, depending on the countries’ resources, and reduce time to patients between four and five months in countries such as Bulgaria, Poland, Romania, where there are significant delays in availability,” she said.

The organisation plans to measure the impact of their commitment through an independent portal run by IQVIA. Moll claimed: “There are a lot of possible reasons for the delays, such as a difference in the requirements for HTA, or duplicative issues and regulatory delays. With the portal, we hope to be able to identify them transparently.”


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