Workshops, online consultations and webinars, social media. ⢠To respond in a timely and evidence-based manner to current debates around access to ...
Access to Affordable Medicines for All
Sam Wing-Sum LI 1,2, Shiva Raj MISHRA 1,3,4
- the Role of Universities and
1. The Lancet Youth Commission on Essential Medicines Policies 2. The Chinese University of Hong Kong, Hong Kong, China 3. Nepal Development Society, Bharatpur-10, Nepal 4. School of Population Health, University of Western Australia, 6009 WA, Australia (We would like to acknowledge all commissioners of YCEMP)
Young People
Why a youth perspective on essential medicines?
• Young people comprise 40% of the world population Little formal political representation and power • Long-term perspective • Different experiences and knowledge than the other decision makers • Less bound by academic or organizational affiliations Workshops with young people • London • Macedonia • Taiwan
The role of YCEMP in advancing the access to medicines agenda
• To carry out an independent assessment of EMP • To produce an independent report with evidence-based policy recommendations •
•
- qualitative data (anecdotes, case studies, and key-informant interviews) - quantitative data (from health systems worldwide)
• To ensure visibility and public involvement Engaging other young people and the public Workshops, online consultations and webinars, social media • To respond in a timely and evidence-based manner to current debates around access to medicines
Rec 2 : Global Cooperation: Reform and Consensus 2.4: Incentivise R&D based on global health needs Innovation Basic Research
2.5: Provide assistance to public research institutions in disseminating their technologies
Research and Development
• Public sector research institutions contributed to the discovery of 21% of new drugs developed recently in the United States • Diversity in structure and organization of TTOs within and across countries • Lack of awareness of licensing options • Stacking of “upstream” patents for basic research results • High portion of exclusive licensing • Little data on universities outside USA and Europe
WHO Model List of Essential Medicines
National Essential Medicines Lists
Manufacture & Qualification
Health Technology Assessment (HTA) Procurement/ Reimbursement Lists Rec 4 : From Bench to Bedside: Translating EMP into Practice
Rec 1 : A New Vision for EML: Consensus and Accountability 1.1: That all countries, irrespective of income levels, adopt NEMLs, which reflect population health needs and best practice in clinical treatment. 1.2: Develop transparent, evidence-based and participatory processes governing inclusion of medicine on NEMLs 1.4: Develop EML scorecard to monitor state progress on NEMLs • The “affordability” criterion : the turning points 2002 – ARVs added 2015 - Expensive meds added • Lack of clarity and understanding in high income countries around the concept of EML
Procurement Supply Chain Management
4.2: Update healthcare service provider curricula regarding pharmaceutical systems and rational use of medicines. 4.3: Develop healthcare service delivery strategies to utilize the skills of professional healthcare workers, nonprofessional healthcare workers and patients
Health Service Delivery Human Resources for Health (HRH) Rational Prescribing
• Australia: medical graduates and pharmacy preregistrants believed generics medicines are inferior in quality, less effective and have more side effects
Payment
Patients
Vision of YCEMP Equitable Access to Quality, Safe, Efficacious and Affordable Medicines for All by 2035 References • • •
• • •
Bigdeli, M., Jacobs, B., Tomson, G., Laing, R., Ghaffar, A., Dujardin, B. and Van Damme, W. (2012). Access to medicines from a health system perspective. Health Policy and Planning, 28(7), pp.692-704. Cameron, A., Ewen, M., Ross-Degnan, D., Ball, D. and Laing, R. (2009). Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. The Lancet, 373(9659), pp.240-249. Cervantes M. (undated), Academic Patenting: How universities and public research organizations are using their intellectual property to boost research and spur innovative start-ups. Available at: http://www.wipo.int/sme/en/documents/academic_patenting.html. Chen, C., Gilliland, C., Purcell, J. and Kishore, S. (2010). The Silent Epidemic of Exclusive University Licensing Policies on Compounds for Neglected Diseases and Beyond. PLoS Negl Trop Dis, 4(3), p.e570. Duong, M., Moles, R., Chaar, B. and Chen, T. (2015). Essential Medicines in a High Income Country: Essential to Whom?. PLOS ONE, 10(12), p.e0143654. Hassali, M., Wong, Z., Alrasheedy, A., Saleem, F., Mohamad Yahaya, A. and Aljadhey, H. (2014). Perspectives of physicians practicing in low and middle income countries towards generic medicines: A narrative review. Health Policy, 117(3), pp.297-310.
Global political momentum for A2M WHO R&D Agreement Global R&D Observatory UN High Level Panel on Access to Medicines
UN SDGs General Assembly
Barriers to access to quality and affordable medicines exist along the pharmaceutical pipeline: R&D system that has been unable to meet population health needs, stringent intellectual property protections restricting access and innovation, lack of pricing transparency, market dominance, and weak health systems that render medicine service delivery and sub-optimal utilization are the systemic challenges to access to medicines in 21st century. Further, as costs of healthcare will continue to rise, and new drugs created, affordability will increasingly become a challenge affected many countries, including high income ones. The Lancet Youth Commission on Essential Medicines Policies (YCEMP) was established in March 2015, with 17 youth commissioners from a variety of fields including clinical medicine, pharmacy, global public health, law, and health economics. Commissions such as this allow for young professionals to be engaged in important conversations in forums worldwide. Young people, being less bound by academic or organizational affiliations, are able to offer more innovative and aspirational thinking towards solutions around the long-standing challenges. In this presentation, two commissioners of YCEMP highlight key evidence-based policy recommendations, with specific focus on the unique role of universities and young people. • Laing, R., Waning, B., Gray, A., Ford, N. and 't Hoen, E. (2003). 25 years of the WHO essential medicines lists: progress and challenges. The Lancet, 361(9370), pp.1723-1729. • Mishra, S., Li, S., Onarheim, K., Lander, F., Barber, M., Sharma, A., Browne, J. and Jarvis, J. (2016). Young people have a new vision for essential medicines. The Lancet Diabetes & Endocrinology, 4(9), pp.733-734. • OECD (2003). Turning Science into Business : Patenting and Licencing at Public Research Organsations. • Penin, J. (2010). On the Consequences of Patenting University Research: Lessons from a Survey of French Academic Inventors. Industry & Innovation, 17(5), pp.445-468. • Stevens, A., Jensen, J., Wyller, K., Kilgore, P., Chatterjee, S. and Rohrbaugh, M. (2011). The Role of Public-Sector Research in the Discovery of Drugs and Vaccines. New England Journal of Medicine, 364(6), pp.535-541. • Toverud, E., Hartmann, K. and Håkonsen, H. (2015). A Systematic Review of Physicians’ and Pharmacists’ Perspectives on Generic Drug Use: What are the Global Challenges?. Appl Health Econ Health Policy, 13(S1), pp.35-45.
