Middle income countries face obstacles in access to drugs despite making them, study finds

27-Feb-2014 - Last updated on 27-Feb-2014 at 09:51 GMT

National prioritization, investments in healthcare infrastructure and building better epidemiological and cost databases could bring more innovative medicines to middle-income countries, according to an independent study conducted by Charles River Associates.

The project was spurred by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which asked Charles River Associates (CRA) to review the evidence on the value of innovation in middle-income countries (MICs) and to test the extent to which the experience of these countries is aligned with the experience of high-income countries (HICs).

The study -- which noted that many of the innovative drugs are manufactured within MICs, notably in India and China -- examined the value of innovation in five key therapy areas: coronary heart disease (CHD), depression, diabetes, HIV/AIDS, and rotavirus infection.

For instance, one of the major diabetes manufacturers stated that the improved products and services they provide saved 140,000 life years in 2010, a number that is expected to grow at an annual rate of 30%, reaching more than 500,000 years in 2015.

In the case of rotavirus, the most common cause of severe diarrhoea among children in both industrialized and developing countries, Tim Wilsdon, CRA VP, said: “We compared the value that two recently-launched vaccines yielded in Brazil and Australia.

“The major benefit seen in both countries was a direct drop in hospitalization costs, but in Brazil we also witnessed a major decline in related mortality rates. So obviously both benefitted from these innovations, but given the nature of the disease burden the added value was greater for Brazil.”

Eduardo Pisani, IFPMA Director General, added: “We now have evidence that in MICs innovative therapies have the potential to create significant value that goes far beyond pricing and reimbursement. Both the social and economic benefits should be taken into account in any calculation of value.”

The study highlights that new therapies are now available but they still need to be adopted more widely. To maximize their value and extend them to broader outreach, countries must first ensure availability of adequate resources. They should also engage in country-specific data collection on epidemiology, and strengthen their health systems to more accurately guide policy and the implementation of programmes for both communicable and non-communicable diseases.

Pisani added that the deployment of specialty drugs in MICs would be a huge boon for preventing premature death.

“If we look closer to coronary heart disease which is by the way the leading cause of premature death and disability for MICs, so far only Brazil, India and China have included cardiovascular diseases within their national plans to fight against non-communicable diseases initiated three years ago,” he said. “The impact is there, yet we see a significant opportunity for more health gains, from the widespread deployment of these new medicines, than ever before.”