Pharmaceutical companies turn attention to developing countries: expensive medicines offered cheaper
The pharmaceutical industry is increasingly trying to offer new life-saving medicines affordably in economically weaker regions of the world, such as in Africa, Latin America, and parts of Asia.
This emerges from research over the past twenty years by the research NGO Access to Medicine Foundation. Today the tenth index was published, a leading biennial study that maps to what extent the world's largest pharmaceutical companies provide people in poor countries access to innovative medicines.
"Setting goals to quickly get costly medicines to patients in these regions was not a priority for most pharmaceutical company executives twenty years ago," says Marijn Verhoef, director at the Access to Medicine Foundation. "That has really changed."
If new medicines did go to poorer countries, which are often expensive due to patents, it was part of a philanthropic program. So these were exceptions. Verhoef: "Now the responsibility for access to medicines in low- and middle-income countries lies with the highest management levels of the pharmaceutical companies."
Affordability
And that is noticeable. Already in the development phase of some new medicines, affordability is considered for countries that find the high costs of new medicines difficult to bear. For example, by partially waiving patents for new medicines in certain regions. Local manufacturers can receive a license to directly produce cheaper generic versions of the medicine.
The new HIV injection lenacapavir from Gilead is a current example. Two injections per year protect HIV-negative people from contracting an HIV infection. It is a medical breakthrough. Large-scale campaigns with this injection could eventually stop the ongoing HIV epidemic in South Africa, provided the medicine becomes widely available.
Normally this takes at least ten years, because only then do the patents expire and cheaper generic versions of the injection come to the South African market. But Gilead is already allowing other manufacturers to produce a cheaper version (40 US dollars per injection) for 120 low- and middle-income countries. The US catalog price of the original medicine is over 28,000 dollars per person per year.
Access extremely important
In South Africa, where about 8 million people live with HIV and thousands of new people contract HIV monthly, they are eagerly awaiting the affordable version of lenacapavir because then it can be offered on a large scale.
"For countries like South Africa, access to this prevention injection is extremely important," says professor Linda-Gail Bekker, one of the leading HIV researchers in South Africa, in her office at the Desmond Tutu Health Foundation in Cape Town. "Innovations are of no use if they are not deployed where they are needed most."
They are experiencing this now in South Africa. Because the expensive original version of lenacapavir is offered with support from the Global Fund, an international fund for, among other things, AIDS control, but due to the high price the supply remains small-scale. "It is actually dripping in slowly, while we need to administer millions of injections to effectively combat new infections. Think of a scale like a vaccination campaign for corona."
Difference for young women
The prevention injection can make a big difference especially for young women. They are at particularly high risk of contracting HIV in South Africa. "The male condom has been the cornerstone of HIV control for years. But not everyone is able to discuss and enforce condom use or safe sex with a partner. In South Africa, about a thousand young women contract HIV every week."
Yet Bekker does not think that access to the injection means the HIV epidemic will come under control in the short term. "Due to the withdrawal of, among others, American aid money, there are fewer resources for, for example, education. Where progress is made in one area, steps are also taken backward in AIDS control." Verhoef from the Access to Medicine Foundation also sees these developments as a serious setback. However, this does not diminish his hope that the development model of this HIV injection, in which ways to make the medicine affordable as quickly as possible are considered already during the research phase, will become the new standard in the pharmaceutical industry.
"Also for other diseases. Cancer or, for example, diabetes do not only occur in the wealthy West," says Verhoef. "There are actually many of these patients in, for example, Africa. We hope the pharmaceutical industry will treat these diseases in the same way as HIV."