Ricardo Marek (left)
President, Growth and Emerging Markets Business Unit
Giles Platford (right)
President, Europe & Canada Business Unit
Q: How does Takeda think about and address access for patients in countries with evolving health care systems, as well as in more developed countries?
Ricardo: As part of our Access to Medicines strategy, we’re committed to addressing the unmet needs of patients wherever they may be and strengthening local health systems at every stage of the patient journey in a sustainable way. I believe a great example of this is our flagship Access to Medicines program — the Blueprint for Innovative Healthcare Access.
In delivering the Blueprint, we believe it’s essential to integrate, not replicate: Through studies into the global burden of noncommunicable diseases (NCDs) and multistakeholder forums, we observed the existence of multiple, parallel activities by international organizations in low- and middle-income countries (LMICs); however, retention rates of patients engaged in these programs were alarmingly low. We also noticed low levels of connection and communication between the provision of medicines to patients and the support available to them, resulting in a less than optimal impact on the management of NCDs.
Leveraging these learnings, the Blueprint project builds on what’s already in place, working to strengthen the existing health care system — rather than developing a parallel program — and working with local government and expert delivery partners. The outcome is self-sustainability and continuity of the program in the long term, well beyond Takeda’s involvement.
The funding of innovative medicines is another challenge in LMICs, where the impact on patients with rare and complex diseases and on their families can be financially catastrophic. We have a multipronged pricing approach which ensures access, including tiered pricing, value-based agreements and Takeda’s Patient Assistance Programs (PAPs), which ensure patients get their entire course of treatment even if they cannot pay for it in full.
Giles: Equitable patient access to innovative treatments is a challenge in developed countries as well. EFPIA published a report in July that showed that patients in neighboring European countries can wait as much as six times longer for access to new medicines. There are multiple root causes for these delays, including administrative delays in health technology assessments, duplicative evidence requirements, complex pricing and reimbursement processes and budget constraints.
Often a major factor, in particular for medicines for rare diseases, is that clinical trials do not produce the quality and amount of evidence that pricing authorities are used to. This is normal, since by definition there are fewer patients. This, however, can make pricing and reimbursement authorities uncertain about the evidence and delay the reimbursement process. Our philosophy at Takeda is to work collaboratively with payors to find constructive and pragmatic solutions. We understand their constraints, and we appreciate that it is only by working collaboratively that we can ensure sustainable long-term access to innovation for patients.
Q: Tell us how Takeda’s approach to access to medicines impacts profit and societal value in emerging markets?
Ricardo: We have created a practical framework to increase access to our medicines through our innovative pricing approaches and initiatives that build capacity across the patient journey — this achieves both societal value and financial sustainability.
Our programs to build capacity and infrastructure — such as the Blueprint project — are run in parallel to our initiatives that address challenges around access and standard of care. When it comes to solving the problem of providing patients in emerging markets with sustainable access to our highly innovative medicines, we take a personalized and collaborative approach through our PAPs.
These programs are designed around individual patients and employ a shared value financing model. The patient shares in the cost of treatment according to what they can afford. Takeda and other partners, including local governments, medical associations and NGOs, contribute the rest, thereby ensuring the patient receives their treatment in full. If everyone pays according to their ability to do so, funds can be committed to patients at lower levels of income, and more patients can be reached, resulting in increased access to medicines for patients and financial sustainability.
In addition, we’ve made a significant strategic decision to transition a number of Takeda countries in our Growth & Emerging Markets business unit to a model whereby locally generated revenues from our innovative medicines for complex and rare diseases will be reinvested in programs that strengthen the local health care system. The transition will take place over the next few years and include countries that have considerable unmet patient need, and that are fraught with high out-of-pocket spend, such as the Philippines, Vietnam, Egypt, South Africa and Sub-Saharan Africa. Aligned with the framework I mentioned earlier, we’ll collaborate with policymakers and experts from NGOs, patient advocacy groups and governments to enable an environment that improves patient access and gives Takeda the ability to drive our medicines’ affordability programs at scale.
Q: Tell us how patient support programs work, and how do they impact profit and societal value?
Giles: We spend considerable time and effort within Takeda thinking about how we can support the patient experience with personalized patient support programs. These programs need to be centered around solutions that are relevant, engaging, impactful and empowering for patients to improve patient outcomes by enabling a connected community and ensuring visibility, transparency and partnership between patients, caregivers and health care providers. Our experience shows that patient support services can offer real value to patients when their voice is heard early enough in the process and their treating physician is engaged in identifying unmet needs in order to create meaningful services.
We recognize the patient journey is not stagnant. That’s why maintaining consistent engagement with patients and patient organizations remains critical as the health care landscape evolves to deliver a better patient experience. This is an area where we as an industry can continue to do more, particularly with the increasing importance of remote care and telemedicine for patients.