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Creative Access Strategies
| Dr Joseph Saba, CEO |
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“Most people with cancer in the developing world die before they get to hospital, and those who get to hospital get there too late. It is a terrible situation. Our first task is to dispel the myth that nothing can be done for these patients because treatment requires sophisticated skills and facilities that are beyond the scope of poor countries, and drugs are too expensive. We shattered this myth with HIV and we must do it too for cancer and other major diseases. Expanding access to the ‘basic’ cancer drugs – essentially chemotherapy – is indeed a challenge, because this requires infrastructure and specialised care in hospitals. But we should also look at others options. We have today new targeted therapies that can be taken orally at home with fewer side effects. These treatments are much better adapted to conditions in developing countries. The big barrier is cost: targeted therapies are expensive. This is where Axios' ‘creative access strategy’ comes in. Experience has shown that donation programmes to poor countries are not sustainable over the long-term, because they depend on the goodwill and healthy finances of the donor. Where donation programmes for cancer drugs are in operation, experience shows that a big segment of the population – perhaps 80% -- does not qualify for free treatment because they are not poor enough. But they are not rich enough to pay for the drugs either -- so they don’t get treatment. Under our creative access strategy, which combines donations with full-price drugs, patients pay what they can afford, with the poorest receiving free treatment. This is a win-win for all parties: all segments of the population gain access to treatment, and pharmaceutical companies gain access to markets – and to many more paying customers – they would not have otherwise reached. The strategy must be tailored to each individual country, depending on analysis of who can afford to pay what. Finding the balance is crucial: if it is not win-win, it is not sustainable. To those who question whether it is ethical for one patient to pay more than another for the same drug, we say drugs cannot just be seen as a commodity, like soap or peanuts. They are part of the continuum of care that is everybody’s human right. This strategy works on the same principle as social security systems in many countries, where people contribute according to their means and all receive the same health benefits. After the hard-won success with antiretrovirals for HIV in the developing world, it is no longer acceptable to say that any country is too poor to get life-saving treatment. More and more companies are receptive to the idea of new business models that will enable them to serve even the poorest patients while still making a profit. What we need now is public conviction that cancer and other chronic diseases can be treated successfully, along with patients and their advocates who demand the services they need. I believe even more promising therapies are on the horizon that will turn cancer into a chronic, manageable disease, as antiretrovirals are doing for HIV. The need for creative strategies to ensure access for all will then only become all the more pressing.” |
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