Covid-19 Drugs: Accessibility, Affordability And Availability

Covid-19 Drugs: Accessibility, Affordability And Availability

Covid-19 continues refusing to unravel the key to neutralize its destructive power – for bringing human life and the socioeconomic fabric of a country back to the old normal again. Just as India, all other countries are, apparently, awaiting a ‘magic bullet’ to come, breaking the shackles of this labyrinth, so to speak.

General expectation is, all concerned will understand that coming out of the new Coronavirus maze, sooner, at any cost – is the only way to bring back life, livelihoods, social fabric and the national economy on to the rail, again. Consequently, every entity in the world would require making moderate sacrifices in this unprecedented endeavor.

Right at this time, accessibility, affordability and availability of emergency use Covid-19 drugs, for various reasons, are going beyond the reach of a large number of the population who need those the most. This is happening not just beyond the shores of India, but in the country, as well, perhaps much more than expected. Interestingly, the issue pertains more to Covid-10 repurposed older drugs, and not so much for vaccines – just yet, as I shall deliberate below.

In this article, I shall focus on this issue, hoping for a reversal of the current trend through active involvement of the both the drug company leadership, and also the national decision makers to safeguard public health interest. Interestingly, the drug pricing issue, mostly with repurposed older drugs, is both global and local. Thus, let me first dwell on the subject of drug price increases during this global public health emergency.

Drug price increases during a global public health emergency: 

According to the July 08, 2020 report of IHS Markit, prices of critical drugs are increasing at a time when they are needed the most, as the governments and individual patients potentially struggle to pay for them.

The findings brought to the fore, prices for the 10 most critical drugs to treat COVID-19 have risen a highly unusual 4 percent globally, during the crisis. The cost for over half of these essential COVID-19 medicines rose across 80 countries between February and June 2020. Let me illustrate this point with one example each of Covid-19 emergency treatment options, starting with the global outcry for the same.

Global skepticism on remdesivir pricing:

As the world anxiously awaits a Covid-19 vaccine to hit the market, an experimental repurposed older drug – remdesivir of Gilead Sciences Inc. was introduced as an emergency treatment option for this infection. Pending detail clinical trial results, currently the drug has received only emergency regulatory approvals with an expectation that it may shorten the recovery period in some severely ill Covid-19 patients.

Gilead Sciences, on June 29, 2020, announced its price of $2,340 for a typical treatment course for people covered by government health programs in the United States and other developed countries.However, it will cost $3,120 for patients with private insurance. This price was swiftly and widely criticized, because the drug has received at least $70 million in public funding toward its development - the report highlighted.

Elaborating what would be affordable pricing for this drug in the developed world, another reportquoted the watchdog group – Public Citizen. This group maintains $1 per day is fair. It points to a cost-recovery model developed by the University of Liverpool, which calculated that the cost of manufacturing remdesivir at scale would be 93 cents per dose, leaving the remainder as, in its view, “a reasonable profit to Gilead,” as the report underscored.

Interestingly, analysts expect Gilead to make $525 million on remdesivir sales this year and $2.1 billion next year. This isn’t the first time Gilead is facing public criticism on life saving drug pricing. Just to recap, in 2013, the company also received ‘brickbats’ for its $84,000 price tag for groundbreaking hepatitis C treatment Sovaldi—followed up by its combo pill Harvoni, priced at $94,500. But those were first in class new and innovative drugs. Nevertheless, the remdesivir pricing issue is viewed differently, because it is not just a repurposed older drug, but indicated to combat a global public health crisis.

Let me now give an Indian example on a similar issue, but with a different anti-Covid-19 drug.

Criticism in India with Covid- 19 drug pricing: 

The Drug Controller General of India (DCGI) had on June19, 2020 approved anti-viral drug favipiravir, manufactured in India...continue reading of Covid-19 Drugs: Accessibility, Affordability And Availability.

Pharma To Leverage The Art of Turning Challenges Into Opportunities, Now

Pharma To Leverage The Art of Turning Challenges Into Opportunities, Now

Since, the dawn of the year 2020, the human population living in different countries, across the world are facing ‘lockdowns in different forms. Although essential, it severely restricts normal daily essential and other important activities of all. A large number of populations in India, is also experiencing the same – for nearly 4 months, almost at a trot, as on date.

The fear of getting infected by COVID-19, fueled by uncertainty about a comprehensive way to surely avert infection and apprehension about what happens if someone gets infected, have been haunting many for several months. Moreover, the possible impact of several related essential measures, such as, social distancing and wearing a mask mostly while being outdoors, on both life and livelihood, is profound. It has already started causing an unprecedented – both physical and mental stress on many individuals, besides the economy of the nation.

Living amid ‘lockdown’ conditions is not just an unpleasant experience for all, it’s almost a ‘prison like’, experience for a vast number of people – particularly, both young and old with comorbidly. “It’s very similar to being trapped in a bunker with no access outside,” as expressed by a person with similar issues, which, may be construed as a universal feeling of common individuals. Interestingly, this was quoted in an article -  ‘What patients need right now’, published in the Reuters Events Pharmaon July 07, 2020. The article also highlighted that many other fellow sufferers, especially non-Covid-19 patients, are enduring pandemic enforced isolation without much hope. “They are staying in limbo until help is available and adapting to the worsening of their health conditions,” the article added.

Further, as captured in the McKinsey article – ‘COVID-19 and commercial pharma: Navigating an uneven recovery,’ published on April 21, 2020 – not just patients, health care professionals including doctors, are also facing unprecedented challenges. Especially, because of the need to address fundamental changes in the treatment of patients with conditions other than COVID-19. This is happening across medical specialties and therapeutic areas, besides of course in advising and treating patients with suspected and confirmed cases of COVID-19.

In some instances, some doctors do also worry about their financial security, as practices and health systems face unprecedented financial issues, the above article emphasized. However, at the same time, many of them are now rapidly adjusting how they deliver care, such as through increased use of telemedicine in different forms and ways, the survey found. Which is why, the support they need from pharma companies is also changing.

Taking cognizance of these critical developments, pharma players would require rewriting their playbook for business operations and for its urgent implementation. This article will focus on this important area of pharma business, by leveraging the art of turning a problem or a challenge into an opportunity.

Leveraging the art of turning a challenge into an opportunity:

Turning a problem or challenge into an opportunity in managing business operations, isn’t a cup of tea of all managers, across domains. More so, when it’s caused by an unprecedented disruptive change, such as the Covid-19 pandemic.

The first and the foremost prerequisite from a manager is a mindset to make it happen – driven by uncluttered thinking, with a clear focus on...continue reading... Pharma To Leverage The Art of Turning Challenges Into Opportunities, Now

In Pharma’s Moment of Truth “What You Do is Who You Are”

In Pharma’s Moment of Truth “What You Do is Who You Are”

Posted on July 13, 2020

It’s a time when pharma industry will be tested, both by its external and internal customers – more than ever before. Looking back, in search of footprints on the sand is no answer either, as there isn’t any. But, a decision on moving ahead has to be made by each drug company in any case – charting a strategic pathway, in search of business excellence, if not for survival. A possibility looms large that the crisis may even overwhelm a company, if any, ill-conceived or ill-thought through steps are taken.

In that sense, the moment of truth has arrived for the industry – a time when ‘what different you do’ in the value delivery process of the business, will decide ‘who you are.’ One’s ability to lead the company or even follow the leadership, to navigate through this crisis, would determine the present and future success of the corporation. This isn’t an easy task. The evolving processes would be challenging to implement, and the traditional mindset may often act as a retarding force, as it were. In this article, I shall explore this critical area with recent examples, as far as possible.

Ability to fathom its most critical component is the bedrock for next steps:

The most critical component in this situation is the ability to make a careful and unbiased assessment of – how different would the ‘new normal’ be from the ‘old normal.’ The focus should not be on the barriers in making the necessary strategic changes, which I hear too often – but how to steer the business through this unprecedented crisis, regardless tough barriers on the way.

Covid-19 threat isn’t going to go away anytime soon:

However, one thing is for sure – no one knows, not just in India, but globally how big the crisis is, and will assume what form, when and how long. Let me give just three illustrations in this area that will be easily understood by all:

• Initially, experts used to say, face masks are required only for those having symptoms and people close to them. “Masks are not required for those who doesn’t have symptoms. Whereas, the same experts are saying these days, “data now emerging about asymptomatic patients spreading the infection across the country, masks play an important role in containing the spread.” Thus, one is required to wear a face mask always while going outdoors.

• Explaining the mode of disease spread, earlier, many experts, including the W.H.O, said that COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes. Thus, a mask is needed when one goes outdoors. Whereas, now the same experts, including the W.H.O, have confirmed that Coronavirus can be airborne indoors. In that case, one may need to wear a mask even indoors.

• On April 23, 2020 the Director-General of Indian Council of Medical Research (ICMR), reportedly, claimed that the situation is stable, and the country has been able to ‘flatten the curve.’ But on May 09, 2020, Director, AIIMS, reportedly, said, “Currently, the cases are continuing to grow at a flat rate, sometimes even more. So, it is very difficult to predict when the peak will come; but it is likely to peak around June or July…” Whereas, an MIT study, which has also been reported in the press reveals, “India might see 2.87 lakh Covid cases per day by February 2021.”

These instances drive home the point – although a serious threat of Covid-19 infection will continue in the foreseeable future, but the way it will manifest itself, and the fresh precautionary measures that will deem necessary, may change with time. Let me give one more example of increasing threat of getting re-infected by Coronavirus by already infected individuals has heightened today than in the past.

The battle tactics need to be updated:

Strategy for war against Covid-19 onslaught may broadly remain similar. But the battle tactics in the multiple fronts need to be updated on an ongoing basis. This needs to be based on increasing or narrowing of the spectrum of threat and other critical factors, as scientific evidences will reveal from time to time.

For example, ...continue reading of In Pharma’s Moment of Truth “What You Do is Who You Are”

Time For Pharma To Leverage ‘The Break In The Clouds’

Time For Pharma To Leverage ‘The Break In The Clouds’

A ‘break in the clouds’ is now clearly visible in the dark and overcast sky – witnessing a global havoc caused by the Coronavirus pandemic in the healthcare space – with its severe socioeconomic consequences. The name of the game to combat this gargantuan crisis in a heavily restricted environment with success, is adding ‘error-free speed’ in all aspects of the planned countermeasures.

This isn’t a very easy task, either. And certainly, is possible with well-integrated digital interventions. From this perspective, one can construe this situation as ‘break in the clouds’ that can be leveraged by pharma companies for digital transformation of their respective business operations.

It may also be interpreted as a blessing in disguise, because such transformation will empower the companies to take appropriate effective measures with speed. When effectively leveraged, such strategic steps will help pharma players in two ways. One, to contain the virus spread while ensuring access to care through business operations. And the second, will help propel the organization to move ahead, even within such a crisis. However, the ‘Digitalization’ process is multifaceted, having, at least two fundamental prerequisites. In this article, I shall focus on this strategic space.

Alternative ways to provide health care is fast gaining ground:

The product and service delivery models of pharma companies are generally built around the concept of physical presence of patients while consulting a doctor or other health care providers. However, Coronavirus pandemic has triggered some significant changes in this area. Let me illustrate this point with some contemporary references.

As the recent L.E.K paper – ‘COVID-19 and the Acceleration of Digital Health in APAC’ emphasized – ‘by sheer necessity, governments and regulators have also reduced the barriers to participation and uptake for remote engagement of consumers, enabling access to care despite social distancing measures,’ during the pandemic. Moreover, a technical guidance paper, published by the World Health Organization (W.H.O) on April 1, 2020 on strengthening health systems against COVID-19, also recognizes ‘telemedicine’ as an alternative model for delivery of care to ensure the continuous running of essential health care.

COVID-19 will take health system digitalization to a new level:

The above L.E.K paper also pointed out – in the days and months ahead, COVID-19 will accelerate the ‘digitalization’ of health systems to a new level. Especially when, healthcare stakeholders adopt a more urgent, no-holds-barred strategy to stem the rising tide of infections. L.E.K article predicted, the new ways of working and behaviors, forged and refined in the heat of battle against COVID-19, will not be easily put “back in the box.” Consequently, this increasingly digitalized reality will force a paradigm shift in the healthcare ecosystem, the paper concluded.

‘A virtually perfect solution’ to neutralize Covid-19 impact: 

Another paper - ‘Virtually Perfect? Telemedicine for Covid-19,’ published in the NEJM on April 30, 2020 wrote, disasters and pandemics pose unique challenges to health care delivery. It underscored, ‘Though telehealth will not solve them all, it’s well suited for scenarios in which infrastructure remains intact and clinicians are available to see patients.’ It also indicated, telemedicine may be a virtually perfect solution, particularly where such infrastructure is available.

‘Governments must reimagine healthcare delivery’:

That ‘Telemedicine can be a COVID-19 game-changer’ - both now, and in a post-pandemic world, was also articulated by another article, published by the World Economic Forum on May 13, 2020. It suggested: ‘Governments must reimagine healthcare delivery in the face of COVID-19.’

This is mainly because, ....continue reading - Time For Pharma To Leverage ‘The Break In The Cloud