Heard on the pipeline: Access to medications

Solving the challenge of access to medication has fuelled many a debate among healthcare stakeholders over the years. Yet, while discussions have been plentiful, even fruitful, patients around the world still struggle to access treatments.

When pharmaphorum editor-in-chief, Jonah Comstock hit the floor of Reuters Pharma US, in Philadelphia last month, it seemed an ideal opportunity to find out what is stalling progress in this space. And so, he put one question to industry experts attending the event.

“What systemic changes are needed to ensure that medications become more accessible and affordable worldwide?”

Mindy McGrath

Senior executive and health industry advisor at Vynamic, an Inizio company

I think our system here in the United States is a very complex system. There are many players within the system – intermediaries, if you will. One thing we’re not doing enough of is talking about the role of the pharmacy benefit manager and that rebating model, which seems very opaque to many in the industry.

I don’t think we’ve had a really good national conversation on the intention of pricing in the United States. There is so much value in pharmaceuticals and yet I don’t think as an industry we’ve done a great job of really articulating and positioning that correctly. And as a result it becomes part of the headline news on a regular basis.

Headline news can be really dangerous because underneath of all of that there is a level of complexity that in many ways doesn’t reside with pharmaceutical companies. It really resides with the intermediaries that play a role in the US healthcare system.

So how do you solve that? You know I’m not big on legislating all over the place but I do think at some point we need to have a very robust conversation about how payment actually occurs through the system and what types of incentives exist. And, candidly, transparency. There are just too many areas in the healthcare system that are not transparent enough, so nobody can really make good decisions on how you actually get to the root cause of this issue.

Watch our full interview with McGrath here.

Lung-I Cheng

VP cell and gene therapy, Cencora

I think drug pricing is part of the equation. It’s a very important piece. But I feel that the question is more around how do we make healthcare more accessible, right? There’s the drug, but it’s the most cost effective medical intervention that you can get, prescription drugs.

There are many other elements where we can find efficiencies. As we think about the health system here in the US and outside the US, what can we do better to make sure that there’s more of an effort to decrease the fragmentation and hopefully therefore improve access to better care?

Watch our full interview with Cheng here.

Mark Morgan

President and head of US operations, UCB Pharma

I think there’s got to be a combination of reasonable legislative solutions and all of the stakeholders – easy to say, hard to do – stepping up to the plate. Because for payers, they most often look at it as unit price. Manufacturers often think more about the patients. If we can stop talking past each other and figure out how we can advocate for solutions together, that may be pie in the sky but I think that’s where the opportunity is.

Even the recent legislation, there’s a lot that as a manufacturer we don’t agree with, there are pieces of it we do agree with it, and yet in the big picture there’s an opportunity to kind of refine a body of legislation like that so it can work for us societally.

Amy Niles

Chief mission officer, Patient Access Network Foundation

You know we’re focused at PAN on the United States. I mean there are lots of issues globally but here in the United States and there are lots of systemic ways that we can improve access to care. If we look at the Medicare reforms that, for example, the Part D cap of $2000 that goes into effect on the 1st of January, that’s great news for Medicare beneficiaries.

But what about everyone else who doesn’t have Medicare insurance? They have high deductibles, they have high costs. So I think from a systemic perspective, we would love to see those costs applied to a broader population.

I think systemically we need to, and this is going to take time and it’s a challenge, but we need to look at the total cost of care. So prescription medications is really important, but that’s just one piece of the pie and we know that the patients we serve are struggling with really high premiums and they pay a co-pay every time they go to a healthcare professional.

All of this adds up and it becomes quite unaffordable for many Americans.
So those are just a couple of ways that I think all of us need to think more broadly.

Meruno Perugini

President, pharmaceutical division, Nestlé Health Sciences

Regulators are looking for a way to make it more affordable for some communities. The Inflation Reduction Act (IRA) is coming our way as a matter of fact and is going to be looking after I guess the Medicare Part D population.

I really believe that the affordability is more and more a component for each of us. Now that cannot be sorted out only by the manufacturer, because the reality is that also health insurance plays a big role in this country together with the government for some of the channels.

I was pretty impressed with some of the discussion on value-based agreements — paying the right price for the value that that the product brings and I believe that that’s very exciting.

One hope that for the future is to go beyond the pharmaceuticals and really looking at the healthcare system overall, right? Pharmaceuticals represent one part, and not the most significant part as a matter of fact, of the healthcare system and the cost of the healthcare system in the US. And I really believe that there is opportunity of getting together and evolving it.

Jonah Comstock is a veteran health tech and digital health reporter. In addition to covering the industry for nearly a decade through articles and podcasts, he is also an oft-seen face at digital health events and on digital health Twitter.

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