How to Build Sustainable Health systems in Latin America

Published Nov 1, 2022

Florencia Davel, VP, General Manager of Bristol Myers Squibb Latin America and Center of Excellence for Local Representatives, Buenos Aires, Argentina

Over the last decades, the development of new health technologies has transformed the way many diseases are treated. To scale up the impact on patients in our region, healthcare stakeholders need to work together to find solutions that prioritize patients as well as the sustainability of health systems.

According to a recent report by PhRMA, American-based companies are currently developing more than 800 potential new treatments for chronic diseases. Over the last decades, there have been transformational changes in the treatment of high-burden diseases such as HIV/ AIDs, HCV and cancer with the launch of a new set of immunotherapy agents. In these areas we have seen the development of breakthroughs that have transformed the way diseases are treated improving patients’ lives.

In 2020, the research-based pharma industry achieved a significant milestone of investing USD 200 Billion in developing new assets. This is 7 times more than the investment in research carried on by the aerospace industry.

Does the new wave of potential breakthrough developments bring an optimistic outlook for patients and HCPs in Latin America? It might, but it might not. It´s up to us to work collaboratively to increase access to innovation while fostering sustainability for health systems.

According to the FIFARMA Patients W.A.I.T Indicator that measures access to innovative medicines in 8 Latin American countries, from 185 innovative oncology and orphan medicines globally approved (from 2014 to 2020), the average availability rate is 13%. Furthermore, regulatory approvals timelines also challenge the availability of innovation: approval times vary from 541 to 1338 days (from 18 months to almost 4 years).

What are the reasons to understand the low adoption of innovative therapies? Budget constraints, fragmented health systems and uncertainty whether the value behind each development is fully perceived. 

We can improve access to innovation in LATAM by working together as stakeholders -pharma industry, health systems, payers, health institutions, HCPs, patients and advocates- with one shared goal:  sustainable patient-centered healthcare systems. This is possible by re designing how innovation is adopted.

There are many proven schemes that can bring a solution for Latin America´s countries. According to a research carried on in Chile by Sergio Poblares “An innovative access agreement (IAA) is a contractual arrangement in which the payment for health care products and services is tied to predetermined, mutually agreed upon terms”. As established by this author, IAAs are designed to reduce unforeseen budget impacts by distributing the risk between the payer and the manufacturer. These agreements can either be guided by financial criteria or clinical patient outcomes.  In either case, the baseline is the same: innovative medicines have a perceived value for patients, HCPs and society. There are examples of how innovative access agreements have been adopted in Chile and Peru.  To extend these best practices, we need to set the adequate framework (such as the correct level of confidentiality) and the right structures in place for an effective monitoring of the agreement in all its implementation phases.

Overall, science and new medicines are essential for human well-being. In 1970, life expectancy was of 59 years. In developed countries it has risen to 80 years since then, thanks to medical innovation and access to health. This is a tangible result that reflects the impact of innovation in societies and drives our commitment as biopharma industry to constantly look for joint solutions in benefit of patients.

Sources:

  • PhRMA. Medicines in Development.  https://phrma.org/Scientific-Innovation/In-The-Pipeline/Medicines-in-Development
  • Deloite centres for health solutions: Ten years on Measuring the return from pharmaceutical innovation 2019
  • Acuerdos de riesgo compartido para medicamentos de alto costo en Chile  (Sergio Poblete )
  • FIFARMA Patients W.A.I.T Indicator
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