Pierre Behnam, general manager of Pierre Fabre in Morocco, which has both dermo-cosmetic and oncology lines of products in its portfolio, outlines that “In the last 15 years, Morocco has made tremendous progress in the prevention, diagnosis and treatment of cancer thanks to the visionary initiatives of His Majesty the King Mohamed VI and health authorities. Although the country started from scratch, Morocco now has a strong network of specialized medical centres for diagnosis and treatment and doctors are well trained.”
In the last 15 years, Morocco has made tremendous progress in the prevention, diagnosis and treatment of cancer
Behnam continues, “The Lalla Salma Foundation against Cancer, which was created in 2005, was instrumental in making the fight against cancer a public health priority in Morocco, improving patient care, and promoting prevention. The Foundation launched an ambitious building campaign, set up the first national cancer registry and put in place early detection projects, among other initiatives.”
Sanaa Sayagh of Roche, which has collaborated with the Lalla Salma Foundation since 2009, notes how public, private and third sector actors have come together on the issue of oncology. “Our partnership with the Foundation was very natural as we share the same objective: improving outcomes for cancer patients,” she proclaims.
Sayagh adds, “The industry has made major advances in 2019 in cancer immunotherapy with several approvals in new cancer types as well as a number of promising breakthroughs with the potential to dramatically improve how patients are treated in the future.”
However, despite this progress, Moroccan patients still struggle to access the latest cancer therapies. Behnam cautions that “access to the latest therapeutic innovations remains the key challenge… We hope to bring some of our new targeted oncology therapies to Moroccan patients in the coming years. The first step is to register the products and receive marketing authorization, but this is a process which takes at least 18 months… Chemotherapy has made cancer treatment easily available and affordable to Moroccan patients. However, it has limitations in terms of efficacy and side effects. New immunotherapies or targeted therapies show great promise in extending survival and possibly curing patients. But as they are targeted at small patient populations with a specific genetic profile, they are more expensive.”
The industry has made major advances in 2019 in cancer immunotherapy with several approvals in new cancer types as well as a number of promising breakthroughs
Behnam is hopeful that a framework for the registration and reimbursement of these new products can be constructed in the near future. “In Morocco, the reimbursement of those therapies is not yet well set. The Ministry of Health, the Department of Drug and Pharmacy (Direction du Médicament et de la Pharmacie, DMP) and the National Agency of Medical Insurance (Agence National de l’Assurance Maladie, ANAM) are working on putting in place access programs for those innovative but expensive treatments. Hopefully, once we complete registration of our new products, a system will already be in place.”
French mid-cap Servier has made great strides in cancer treatments globally with several product launches after acquiring the oncology branch of Shire and forming strategic partnerships. Guillaume Recorbet, the company’s Morocco general manager shares Behnam’s concerns about the lack of a reimbursement framework for innovative new therapies but is also hopeful that better structures will emerge in the context of the Health Plan 2025 rollout.
He posits that “Reaching universal coverage is an objective shared among all actors in the healthcare sector. Nevertheless, there is still a long way to go to reach this goal. Without proper reimbursement, the vast majority of Moroccan patients cannot have access to innovative oncology therapies, even though they might be registered on the market, as they do not have the means necessary to shoulder the cost of treatment. In the difficulties of getting reimbursement, companies cannot bring their innovative therapies profitably on the market. However, as health coverage progresses, I am confident that Servier and other biopharma companies will reassess the situation. Our aim is to bring innovative cancer treatment solutions to Moroccan patients as soon as possible.”
Without proper reimbursement, the vast majority of Moroccan patients cannot have access to innovative oncology therapies
For Roche’s Sayagh, greater inter-stakeholder collaboration could be the key to solving the access issues facing new oncology treatments. “What has been achieved in the last 15 years is fantastic, but there is more to be done for Moroccans to access the latest therapies,” she warns. “We realize that funding innovation is not an easy task, especially in a developing country like Morocco. This is the reason why we collaborate closely with key stakeholders, including the Ministry of Health, the ANAM, university hospitals, and other pharma companies, to think creatively on how we can enlarge access to innovation and co-create access programs adapted to the local context.”
Sayagh adds that a more complete uptake of digital solutions could also be crucial. “The informatization of the healthcare system is key to implementing creative access solutions: we need to be able to gather anonymous health data to implement these new access solutions. Health authorities are aware of the need to upgrade the health IT infrastructure. There are very interesting initiatives already running in some oncology centres such as the one developed in the National Institute of Oncology in Rabat. While we could wait until the right IT infrastructure is in place, we could take a proactive approach to adapt ourselves to the existing environment and start with simple and compliant processes.”
These simple and compliant processes to ensure that Moroccan cancer patients can access the latest innovative therapies include Roche’s work with the Lalla Salma Foundation. “We think that Moroccan patients deserve to access the latest therapeutic innovations, no matter their income level,” states Sayagh. “Our joint program allows 1,500 patients per year to access cancer therapies. Our contribution is not only limited to providing innovative products, we also share our knowledge and know-how and participate in several actions within the national cancer control plan, such as awareness campaigns, research, and medical education.”