Sharing experience of expanding access to medicines

expanding access to medicines

2018 was a challenging year for pharma companies. While our industry continues to discover and develop treatments that improve lives throughout the world, trust with the public is near an all-time low. One reason for this is clear: for all the progress we’ve made, billions of people worldwide still lack access to essential medicines. Patrice Matchaba explores Novartis’ experience of expanding access to medicines.

Whether a major research and development company or a generic manufacturer, pharmaceutical companies can no longer afford to produce medical breakthroughs in a vacuum. We all understand that medicines aren’t much use without proper diagnostics or a reliable healthcare system to deliver them.

But it goes deeper than that. To beat complex global health challenges like noncommunicable diseases – which could be draining the global economy by as much as USD 47 trillion by 2030 – we must dig deep and inspire each other to a greater purpose.

With this in mind, I would like to highlight some key insights in helping to expand access to medicines. It is my hope that our efforts will inform and inspire others in the industry as we strive to do better together.

Increasing access to medicines must become part of core business

Novartis has history of working to increase access to medicines. In 1981, we began donating leprosy drugs, playing a part in slashing the disease by 99% globally. To tackle greater global health challenges like malaria – a leading killer of African children – we expanded our production of artemisinin-based combination therapies and distributed more than 850 million treatments without profit, including 350 million paediatric doses, contributing to a 50% drop in malaria deaths since 2001. And we have devised a new social business approach to provide medicines to lower-income countries through a strategy that stimulates sustainable market development.

But achieving the UN goal of Universal Health Coverage by 2030 – and maximising the social impact of our work throughout the world – requires a fundamental shift in the way pharma operates. We’ve asked ourselves: How can we do even more? And other companies should be doing the same.

The conclusion we’ve reached is that access must become an integral part of our business strategy. We adopted new Access Principles to guide our work and formally committed to:

  • Systematically assess our research and development portfolio against the unmet health needs of under-served populations;
  • Help improve the affordability of our medicines; and
  • Systematically assess our efforts to strengthen local healthcare systems.

As a result, we will now have a dedicated access strategy for every new medicine we launch, with a goal of ensuring that we maximise the reach and social impact of our innovations. Furthermore, our chief executive and executive committee members will have an access objective as part of their individual objectives – signalling that a commitment to change starts at the top.

This is something that could be adopted across the wider industry.

Measurement and evaluation are essential to success

To have any hope of achieving the UN goal of Universal Health Coverage by 2030, both public and private players must drastically increase funding to strengthen health systems. There are encouraging signals from the innovative financing sector. According to a 2018 survey by the Global Impact Investing Network, approximately USD 11.4 billion has been invested by impact investors (e.g. fund managers, foundations and other organisations) through a mix of debt and equity instruments specifically in healthcare. This shows an appetite from investors for financing development goals – provided there is a clear return on investment.

The science of measurement and evaluation (M&E) in this area is far from settled – there are no consistent standards or guidelines for demonstrating the impact of large-scale health investments. But this only underscores the wider point about the path to progress: access is a challenge that society can only conquer through a constant commitment to learning and improving.

Novartis is sharing openly and honestly with our partners and patients, holding ourselves to higher standards, and committing to continually do better. To this end, we are working with Boston University researchers to evaluate the impact of Novartis Access in Kenya, a social business programme that provides 15 commonly-prescribed drugs against chronic conditions to lower-income countries for USD 1 per treatment per month. We hope this effort will produce not only evidence of increasing access to affordable medicines, but also guidance on how similar programmes can evaluate their impact. This should then help with replication across the industry.

Time to solve global health problems

By putting access at the core of business strategies and committing to rigorous evaluation of the social impact of work, companies can build greater trust with society while helping to solve the world’s most pressing global health problems. Looking into 2019, let’s be motivated by a spirit of optimism and all the good that we can achieve together.