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Essential Medicines in LMICs: A Close Look at Efforts by Top Pharma Players

Sep 28, 2023 #LMICs
New analysis looks at efforts of 5 major companies to expand access to Generic & Biosimilar Medicines in low- and middle-income countries (LMICs).
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  • Along with detailed company profiles, the report identifies key findings and opportunities to strengthen manufacturing and improve availability of generic and biosimilar medicines.
  • In 90 of the 108 countries in scope, at least one of the companies has registered a product – but for the essential medicines analysed in more detail, companies vary significantly in their registration practices in LMICs

the inaugural report from the Access to Medicine Foundation’s Generic & Biosimilar Medicines Programme takes an in-depth look at what five major industry players are doing to expand access to their products in low- and middle-income countries (LMICs).

The report marks the first time that any generic or biosimilar medicine manufacturers have been assessed in-depth on their access-to-medicine efforts. This first iteration profiles Cipla, Hikma, Sun Pharma, Teva and Viatris, analysing their engagement in access and highlighting opportunities to address gaps in affordable and reliable access to the quality-assured essential medicines produced by these companies.

Generic and biosimilar medicines can serve as lifelines to millions. Of the medicines classed as “essential” by the World Health Organization (WHO), 90% are off patent, including treatments for cancers, heart disease, epilepsy, diabetes, maternal haemorrhage, bacterial infection, tuberculosis, malaria and HIV. Once a patent for a medicine expires, other drug manufacturers are free to develop a generic or biosimilar version and enter the market, potentially introducing competition and increasing supply. Not only do generics and biosimilars offer the same therapeutic and clinical benefits as the originator medicines, but they are often supplied at a much lower cost. Some of these companies now also manufacture generic or biosimilar versions of patented products under voluntary licensing agreements, which can expand and accelerate access to innovative medicines worldwide.

However, generic and biosimilar products are still out of reach for many patients in LMICs, especially those living in low-income countries and those from vulnerable populations. Even if a product is comparatively cheaper, payers may still not be able to afford it – including healthcare authorities in LMICs, as well as individuals who rely on paying out of pocket for their healthcare – and there are also significant availability issues. The world’s leading producers of generic and biosimilar medicines occupy a central position in the global health landscape, and they can use this to expand access to essential medicines.

“When it comes to expanding access to medicine, the power of the generics industry is often underestimated. It’s more than the transactional relationship of selling drugs at volume and competing on price. Companies must engage with the unmet medical need globally – for example, by working with local manufacturers to improve supply, by taking steps to safeguard quality, by

making their essential products available in more countries, and by addressing affordability for the poorest patients.” – Jayasree K Iyer, Chief Executive Officer, Access to Medicine Foundation.

Using the Analytical Framework, a first-of-its-kind assessment tool developed by the Foundation’s newly established Generic & Biosimilar Medicines Programme, this data-driven analysis zooms in on the actions of five companies chosen for their size, influence and involvement in global health: Cipla, Hikma, Sun Pharma, Teva and Viatris. Collectively, these five companies have a wide portfolio of essential medicines and a well-established presence in LMICs.

What did the report find?

  • Companies have a collectively broad regulatory footprint in LMICs, yet many essential products are not widely registered
  • Companies are using access strategies to expand access to their products in LMICs, yet efforts fall short for the poorest patients
  • Despite initiatives to strengthen manufacturing, further efforts needed to safeguard product availability
  • Companies are engaging in adaptive R&D, tailoring products to the needs of people in LMICs

“For the very first time, we’re shining a spotlight on the actions, efforts, and commitments of leading generic and biosimilar medicine manufacturers to broaden access to lifesaving medicines in LMICs. Although there are standout examples of action, clear opportunities also exist for companies to ramp up their efforts and to work closely with local implementers, governments, and global health organisations to continue to break down barriers for the millions who either lack adequate access or are forced to go without the medicines they need.’ – Claudia Martínez, Research Programme Manager, Generic & Biosimilar Medicines Programme

Opportunities to make an impact

Given their portfolios and footprints, these five companies – Cipla, Hikma, Sun Pharma, Teva and Viatris – can have a huge impact on access in LMICs, as can the wider generics industry. The report identifies opportunities for each company to significantly enhance its impact and contribute to improving access to medicine in LMICs, with recommendations tailored to the specific circumstances of each company, as well as its portfolio, geographical reach and size. By acting on these opportunities, and by making access to medicine a priority, companies can ensure that their products reach the people who need them most – no matter where they live.

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