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Noncommunicable Diseases, Access, and the Pharmaceutical Industry

Hypertension. Cancer. Diabetes. COPD. Those are all non-communicable diseases (NCDs) traditionally depicted as the privilege of wealthy societies basking in their comfortable lifestyle of unhealthy diet and physical inactivity. Worldwide, NCDs account for 60% (35 million) of global deaths. Yet, contrary to common perception, the largest burden occurs in low- to middle-income countries (LMICs): more than 70% of all cancer deaths and 80% of deaths from heart attacks and strokes occur in LMICs, for example, and a frightening time bomb is ticking in several countries like Thailand where obesity in adolescents increased by 33% in the past two years.

Given their impact on morbidity and mortality in LMICs, NCDs are and will increasingly be a major cause of poverty and therefore call for immediate development action. Recognizing the urgency, the global health community will be gathering at the first ever UN Summit on NCDs in September 2011.

In LMICs, the NCD problem is compounded by poor access to medicines and healthcare services, which will likely be the biggest barrier to overcome. Pharmaceutical companies are more and more expected to play a central role in access given the relevance of their drug portfolios to NCDs. At the same time, it is becoming a business opportunity. Emerging markets like Brazil, Russia, India, China, Mexico or Turkey are exhibiting double-digit growth and outpacing sales progression in traditional pharma markets such as the US, the UK, France or Germany. Even less mature markets like South Africa represent latent opportunities that, despite their relatively small contribution today, might fuel pharma’s growth engine tomorrow. In mature markets, the ‘patent cliff’ is casting doubt on the ability of the classic blockbuster model to further sustain pharma returns in future. Timing, it appears, has maybe never been so opportune to engage the industry giants on the issue of access to healthcare and devise collaborative approaches between private and public stakeholders that build on each other’s strengths and deliver social impact whilst sustaining the business – an alignment of interest FSG commonly refers to as ‘shared value’.

In the past, access contributions from pharma companies have been mostly limited to funding global and local third party-led initiatives and donating products. Although highly commendable efforts, these traditional CSR approaches typically lack scaling and sustainability potential. Going forward, successful access programs will need to be focused and goal-oriented – on specific diseases, geographies, and population groups – with robust programs that address several key bottlenecks simultaneously; of those, strengthening healthcare systems and infrastructure, increasing affordability of medicines, and driving adoption through education and awareness building will certainly be of paramount importance.

Recently, some pharma companies have pioneered innovative affordability models to increase access to medicines in a sustainable way: GSK, for example, is testing tiered pricing approaches in LMICs and set up an HIV/AIDS joint venture with Pfizer, opening up the entire drug line to generics manufacturers to produce and sell drugs at significantly reduced prices in developing countries. Those are encouraging signals that the pharma industry is rising more widely to meet the access challenge and turn it into an opportunity. In the past few months, FSG has been involved with several companies to rethink their access to healthcare strategies and sketch original programs addressing key access issues in a systemic and collaborative way.

We will be very excited to see those early efforts bear fruit in the coming years and to continue being involved with pharma stakeholders as they learn from those pilots and devise innovative, larger-scale approaches that can positively impact global health whilst preserving – or even growing – their bottom line.

Sebastien Mazzuri

Managing Director