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Access to medicines

Access to medicines Agency Consulting firm Experts Specialists Consultancy

Improve access to treatments for people living in low- and middle-income countries

Our specialized team works on the drivers and barriers to access to medicines, and supports healthcare players in building wider access to treatments.

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    The challenges related to access to medicines

    It is still a significant issue in many countries and is a prominent topic regarding world health. Although progress has been made in recent years, there are still many parts of the world where the access to timely care & medicine is questionable and remains a challenge.

    The key challenges for a broad, seamless access to medicines are simple : affordability, encompassing the question of price and reimbursement by health insurance systems, and physical availability, ie supply chain performance. Also, the lack of information about the products often prevents their large-scale use by the adequate patient population.

    In addition to these major concerns, we must not forget that even in the most developed nations, access to medicine is not equally granted in the population, and availability for subpopulation such as children can be limited.

    In the following paragraphs, we will explore the key challenges and the solutions envisaged to meet them.

    The high price of drugs is a global barrier, especially in low and middle income countries where the price is not strictly regulated and make it difficult for the people to afford the necessary therapies & medicine they need. At global level, intellectual property rights such as a patent also create barriers by limiting competitive supply and have monopoly over price setting. The access to an innovative drug is therefore especially challenging, as these drugs are typically protected by a patent for many years to come. The focus and numerous incentives of governments around the world in favor of generic drugs are an attempt to enhance access to medicine. To be noticed, in 2023, a new European law restricts the market exclusivity of a new drug to 8 years (instead of 10 years).

    What are the key strategies pharma companies deploy to enable financial access to medicine worldwide? Which pricing strategies are used to differentiate between developed & developing countries?

    Another challenge is the limited resources of certain medications, particularly in emerging economies. This is often due to supply-chain-related shortages due to shipment delays and customs halts, regulatory barriers or the general lack of funding for public health programs. Moreover, the availability of a medicine is also impacted by inequitable distribution of such medicines. The distribution is not uniform in the world, with a large difference between the developed & developing world, leading to disparities in health outcomes. These differences in distribution rely on the different levels of robustness of the supply chain, notably with a clear difference between developing & developed nations.

    What are the key supply-chain related bottlenecks in the distribution of medical products? What are the most common regulatory barriers? Which strategies can be envisioned to facilitate the access to medicine in hard-to-reach areas, and what solutions are already in use?

    A lack of awareness about a drug can also be a large barrier. Both patients and caregivers may not be aware of all the therapeutic options available to them for a particular indication, limiting the scope of recommendations and use. Moreover, medical professionals may not have the information they need to make informed decisions about which drug to prescribe, and similarly patients may not have the necessary information about the arsenal of medications to choose from for their specific conditions.

    What are the most efficient tools to use to communicate with medical providers & patients about the availability of a new treatment for a specific indication? What are the current strategies of various players in raising awareness about their therapeutic arsenal? What is the level of acceptance of medical professionals regarding direct approaches by the industry?

    Insurance-related issues can be a major barrier, especially where costs are high and insurance coverage is limited. Generally speaking, uninsured populations have the largest trouble accessing timely care, due to the limited basic coverage of the national health system. High deductibles and co-pays are also a major barrier to the accessibility of quality and essential cares and drugs, as many people in emerging economies cannot afford them. Many insurance schemes apply restrictions on formularies, restricting treatments available under their plans and require prior authorization for certain medicines. Lastly, there is often only limited coverage for specialty medicines, notably for rare diseases, which can be very expensive and therefore pose a large barrier for the patient to access such treatments.

    What are the key issues & gaps to fill in the national insurance systems of developing countries? Where can pharma companies intervene in the insurance landscape to enhance the accessibility of quality and essential cares and drugs? Who are the key stakeholders in the insurance landscape, and what is the general set-up of insurance systems?

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      How we support you in your projects related to access to medicines

      For close to 30 years, Alcimed has been supporting its clients on numerous issues related to access to medicines, regarding various facets of the topic. Indeed, Alcimed has carried out more than 100 projects in his field, for different players such as:

      • National and European institutions and research centers (for example, the European Commission, INCa, AFM/Genethon).
      • European and North American biopharmaceutical and pharmaceutical companies and biotechnology companies such as Genzyme (Sanofi), Shire (Takeda), Endo, Amgen, Chiron, Actelion (J&J), Alexion (Astrazeneca), PTC Therapeutics, Vertex, Sanofi, J&J, Roche, Merck-Serono, Novartis, Novagali (Santen), Spark Therapeutics (Roche), Insmed, Bone Therapeutics, Cellectis, NPS Pharma (Takeda), Intermune (Roche) and others.

      The diversity of our clients (pharmas, biotechs, research centers, professional associations, national or European institutions, etc.), the geographical fields we explore and the types of projects we carry out gives us a comprehensive and in-depth understanding of the issues addressed in the field of access to medicines.

      Our projects cover topics as diverse as the development of generics or biosimilars in across the world, new funding mechanisms and P&R schemes, search for production or distribution partners, regulation analysis, Go-To-Market strategies, including market access strategies, organization of health systems across the world, etc.

      What they say

      • TCV_biomerieux_miniature_site_EN
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        Bertrand Mérot

        CEO

      Examples of recent projects carried out for our clients in access to medicines

      • Supporting a biotech in the search for potential partners for biosimilars to enhance their access to medicines strategy

        Alcimed supported an emerging biotech in the search for partners to set up a novel bioproduction technology aiming to produce more affordable, and consequentially more accessible, pharmaceutical products (biosimilars) in developing countries.

        To do so, our team helped in identifying funding sources, organizations and potential partners to set up the technology and the production platform of our client in the designated low- and middle-income countries.

        In this project, we exchanged with Key Opinion Leaders (KOLs) promoting local drug production and access to medicines in the countries in-scope, as well as started discussions with international organizations providing funds for the establishment of healthcare production facilities in low-income countries such as NGOs, investment funds & governmental organizations.

      • Supporting a client in understanding the diabetes public health environment in 6 emerging countries to develop partnerships in global health with regards to accessibility of medicines

        Alcimed supported its client in understanding the international diabetes public health environment in China, Brazil, Nigeria, Egypt, India & Indonesia, as a first step in the search for opportunities and most suitable topics to develop.

        Our team mapped the key stakeholders, influencers, policy makers and policy shapers in the diabetes landscape in the in-scope countries. An in-depth literature analysis and interviews with key stakeholders were performed to landscape the integral diabetes environment in each country, including diabetes policies and related unmet needs.

        Our team also performed a gap analysis of the most important topics in each country, the programs already implemented in diabetes and the most promising projects to implement in terms of social, medical and access/availability issues.

      • Comprehensive analysis of the organization of the Brazilian health system to identify gaps to fill in access to medicines

        In a project scoping Brasil for a leading health company, Alcimed has completed an international large-scale comprehensive analysis of the health expenditures, the organization of the health system characteristics, the key drivers of the decentralization of the public health scheme and the related regulatory developments.

        In this project, our client gained an overarching view of the Brazilian organization of the health system as well as the shortcomings of the current scheme and related gaps to fill, where there is an opportunity to improve access to treatments.

        Moreover, we also investigated the various stakeholders and insurance systems of Brazil, to identify the key audiences to engage with and availability of medicines strategy.

      • Supporting a large pharmaceutical company in framing access to medicines scenarios

        Alcimed supported a large pharmaceutical player in framing their strategy to improve access to medicine in countries with insufficient health resources to treat their patients, beyond their already active strategy in a few focus areas.

        To do so, we broadened the scope of the access to medicines strategy for our client in various disease areas, as well as helped re-think their access to medicine approach in the future.

        Our team mapped and analyzed the various strategies of other pharmaceutical companies and institutions in order to derive best practices and anticipate difficulties, prior to organizing and moderating collaborative workshops to imagine the best strategy for our client.

      • Understanding of the psychological barriers in flu vaccination to increase awareness for a leading pharmaceutical company

        Alcimed worked with a leading pharmaceutical player to enhance their public communications to boost flu vaccination awareness among targeted populations in Indonesia.

        Our team mapped the current initiatives by key public health stakeholders (healthcare providers, medical institutions, government agencies etc.), conducted in-depth literature analysis and interviews with groups of interest to evaluate the underlying psychological barriers and their potential impacts on vaccination adoption.

        Based on the opportunities and barriers identified in this project, we could identify the key barriers for boosting flu vaccination awareness and provide insights for our client to formulate strategic engagement with targeted groups through different communication channels.

      • Implementation of the access to medicine pillar of a leading pharmaceutical company in its global CSR roadmap

        Alcimed supported a leading pharmaceutical company in implementing a key pillar of its global CSR roadmap, which focused on increasing access to medicine in countries with high medical needs.

        In the first step, we mapped underserved countries with no established medical infrastructure and reimbursement models to identify priority issues specific to access of medicine. Internal interviews and knowledge review were then conducted with the client to co-identify and shortlist potential partners to work with in its global CSR roadmap.

        In the end, our work enabled our client to create a fact-supported global CSR strategy and roadmap for access to medicine in underserved countries.

      • Preparing the launch and access strategy of a new CAR-T therapy

        We assisted a leading player in the field of CAR-T therapies in preparing the launch of its new treatment and in defining its market access strategy in the United States, Canada and Europe. CAR-Ts are highly personalized technologies that require a high level of specialization to be delivered to patients, and therefore not all healthcare centers are ready to administer them. In this context, and in order to define the market access strategy for its new treatment, we helped our client to:

        1. Understand and identify which centers would have the capacity to deliver CAR-Ts.
        2. Analyze the bottlenecks for approval in the in-scope markets.
        3. Consequently, define the actions to be implemented to ensure access to its new CAR-T therapy.

        After an investigation conducted in more than 200 healthcare centers in the United States, Canada and Europe, our analysis brought us to recommend to our client the next key steps to be taken in order to develop the skills of each center and to promote rapid access to their new treatment.

      • Improving access to care through telemedicine solutions in women’s health

        While telemedicine is a rapidly developing channel of access to care in e-health, it is also a potential means for the industry to implement complementary services for professionals and patients.

        Alcimed supported an international pharmaceutical player in building a business case in women’s health, highlighting how services based on teleconsultation platforms could create value.

        The project concluded with the implementation of three pilot programs with start-ups in the sector in France, Germany and Russia.

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        To go further

        Founded in 1993, Alcimed is an innovation and new business consulting firm, specializing in innovation driven sectors: life sciences (healthcare, biotech, agrifood), energy, environment, mobility, chemicals, materials, cosmetics, aeronautics, space and defence.

        Our purpose? Helping both private and public decision-makers explore and develop their uncharted territories: new technologies, new offers, new geographies, possible futures, and new ways to innovate.

        Located across eight offices around the world (France, Europe, Singapore and the United States), our team is made up of 220 highly-qualified, multicultural and passionate explorers, with a blended science/technology and business culture.

        Our dream? To build a team of 1,000 explorers, to design tomorrow’s world hand in hand with our clients.

        Access to medicines refers to the population’s ability to obtain affordable, safe and effective health services & medicines when they need them. The access to essential cares is a high priority stake regarding world health, especially important in middle income & developing nations.

        The availability of medicines is the degree to which a drug is present at various distribution points in a defined area for the population living in that area at the time of need.

        Improving access to medicine is a complex question that requires the involvement of stakeholders on multiple levels.

        Identifying current barriers hindering access to medicine in the particular country is important. Barriers can include awareness, affordability, availability, limited infrastructure, regulatory etc.

        Key influencers (doctors, patients, regulators, policy makers, companies) who are impactful to the particular healthcare system should then be identified to partner and drive various initiatives on the government, industry and social level.