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Access to medicines
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Access to medicines
Access to sustainable health care
Making access to health care possible for all people – this is a goal that Bayer is working towards through a broad-based alliance of international bodies, governments, companies and non-governmental organizations. Because this is a goal that can only be achieved by working together. The primary role played by Bayer HealthCare in this endeavor is that of providing and developing medicinal products.
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| Dr. Ulrich Köstlin, member of the Executive Committee of Bayer HealthCare AG “We view our efforts to achieve sustainable health care as a central element of our corporate responsibility.” |
Partnerships for health
For many years Bayer has been directing its efforts at improving people’s access to medicines. The United Nations (U.N.) established health as a fundamental right in its Universal Declaration of Human Rights, and health is also one of the main focuses of the U.N.’s Millennium Development Goals.
“Our involvement is based on partnerships,” Köstlin explains. “We know that in many countries joint action is the only way to overcome the problem of inadequate health care. Government bodies, industry and society as a whole must join forces and contribute their specific expertise to this task.”
This is why Bayer is a member of numerous public-private partnerships (PPPS) whose aim is to facilitate access to medicines, to improve health education, to increase the level of knowledge of health care providers through training, and to jointly develop drugs for new indications.
An important partner for Bayer is the World Health Organization (WHO), with which the company is cooperating on two projects. Bayer is supporting the WHO’s goal of eliminating Chagas disease, a parasitic infection rife in Latin America, by 2010. The company is providing at no charge 2.5 million tablets of the active ingredient nifurtimox and additional funding for the next five years. Bayer has been supplying the who with medicines containing suramin free of charge since 2002 as part of the organization’s efforts to control African sleeping sickness, a disease which poses a risk for almost 60 million people in Africa.
Innovations provide solutions
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There is also an urgent need for action with respect to diseases which have been neglected, foremost among them the tropical diseases. Bayer HealthCare is a member of a working group set up by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) to develop multidisciplinary projects which aim to promote research into tropical diseases for which therapy is currently inadequate. The company also supports clinical studies sponsored by the who which are investigating whether the active ingredient nifurtimox, which was originally developed to combat Chagas disease, could also be used to treat sleeping sickness.
At the same time, Bayer CropScience is collaborating with the Innovative Vector Control Consortium (IVCC) on research into new, effective approaches to controlling malaria and other insect-borne diseases. Two research projects are currently ongoing to investigate ways of protecting the inside of dwellings against the vectors which transmit diseases and to identify approaches to solving the problem of resistance in existing active ingredients.
When Bayer develops new products or refines existing ones, it also examines the feasibility of expanding their spectrum of application to include the treatment of neglected diseases.
Future oriented family planning
Women’s health and family planning are central aspects of efforts to achieve better health care worldwide. “We want to give destitute women as well the option of planning their families the way they want, to lower maternal and infant mortality, and to strengthen women’s position in society,” Köstlin says. Bayer provides support especially for women in developing countries, giving them access to a range of family planning methods irrespective of their income. Under these programs, Bayer supplies family planning organizations with oral contraceptives at cost price, and also distributes contraceptive implants and intrauterine systems. Local distribution is ensured through a global network of governmental and non-governmental organizations, among them the United Nations Population Fund (UNFPA) and the International Planned Parenthood Federation (IPPF). The company works with various stakeholders such as the German Federal Ministry for Economic Cooperation and Development, the development loan corporation KFW, the international cooperation enterprise GTZ GmbH, the German Foundation for World Population (DSW), the human-resource development organization InWent Capacity Building International and the IPPF to organize the annual International Dialogue on Population and Sustainable Development conference, the aim of which is to drive cooperation between policy-makers, governmental and non-governmental organizations, the scientific community and industry. In December 2007, Bayer became the first industrial member of the Reproductive Health Supplies Coalition (RHSC), an alliance of multilateral organizations, foundations and non-governmental organizations. Bayer can draw on many years of experience and enormous expertise in family planning, and is consequently seeking to expand its global involvement in self-determined family planning.
Access to medicines is just one of several factors which need to be integrated in order to ensure sustainable health care. It is therefore not something that can be provided by the manufacturers of the medicines alone.
The necessary infrastructure, such as roads passable by vehicles and the vehicles themselves, must exist. A health care infrastructure also needs to be available in the country concerned. This means hospitals or treatment centers and sufficient medical staff – doctors and nurses – without which patients cannot be treated successfully. And finally, patients have to be taught how to handle the medicines, how to use them correctly and how long treatment needs to last.
Governments, international bodies, aid organizations and possibly even other sectors of industry need to work together in public-private partnerships (PPPS) if the associated challenges are to be addressed efficiently.
The necessary infrastructure, such as roads passable by vehicles and the vehicles themselves, must exist. A health care infrastructure also needs to be available in the country concerned. This means hospitals or treatment centers and sufficient medical staff – doctors and nurses – without which patients cannot be treated successfully. And finally, patients have to be taught how to handle the medicines, how to use them correctly and how long treatment needs to last.
Governments, international bodies, aid organizations and possibly even other sectors of industry need to work together in public-private partnerships (PPPS) if the associated challenges are to be addressed efficiently.
Patent protection preserves research
Without effective protection of intellectual property there would be no incentive for companies like Bayer to invest in the expensive, time-consuming and economically risky development of new medicinal products. Patents allow research-based companies to recoup part of the considerable costs incurred through their work, including the cost of projects which don’t make it to the market. “We are convinced that effective patent protection is the only way to make the necessary innovations possible,” Köstlin emphasizes. This includes compliance with the rules of the TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights), the purpose of which is to enforce intellectual property rights in national legal systems. The simple message is that patent protection and access to low-cost medicines are not incompatible.
Individual pricing
Bayer is naturally aware that the price of medicines plays an important role in efforts to achieve sustainable health care. “This is why we have developed a differentiated pricing strategy that takes account of the economic situation in each country. Individual agreements with national governments enable us to ensure that patients in poorer countries can also benefit from our innovative medicines. In some countries we even distribute our medicines free of charge,” is how Köstlin explains the differentiated approach that Bayer takes to pricing.
Enormous social inequality is frequently encountered in countries with an emerging economy, and the company has launched special programs to assist patients in such countries – and even in some industrialized countries – who cannot afford certain medicines. One of these programs is currently running in Asia to assist people who need a drug to treat kidney cancer which contains the active ingredient sorafenib. Another program enables low-income patients in the United States who have multiple sclerosis (MS) to receive treatment at an affordable price.
In the world’s poorest countries Bayer is currently not seeking to enforce its patent rights and does not intend to register patent rights there in the near future. Moreover, some 95 percent of the products on the who’s Essential Drug List are off-patent. This enables manufacturers of generic products to produce their own versions of them. In addition to proprietary brands, low-cost off-patent medicines are thus also available to treat many of the diseases that affect people in developing countries.
Enormous social inequality is frequently encountered in countries with an emerging economy, and the company has launched special programs to assist patients in such countries – and even in some industrialized countries – who cannot afford certain medicines. One of these programs is currently running in Asia to assist people who need a drug to treat kidney cancer which contains the active ingredient sorafenib. Another program enables low-income patients in the United States who have multiple sclerosis (MS) to receive treatment at an affordable price.
In the world’s poorest countries Bayer is currently not seeking to enforce its patent rights and does not intend to register patent rights there in the near future. Moreover, some 95 percent of the products on the who’s Essential Drug List are off-patent. This enables manufacturers of generic products to produce their own versions of them. In addition to proprietary brands, low-cost off-patent medicines are thus also available to treat many of the diseases that affect people in developing countries.
Countering counterfeit products
Counterfeit medicines represent a serious problem in the quest for sustainable health care. The World Health Organization estimates that up to 10 percent of the medicines distributed in developing countries are counterfeit products. In some parts of Africa, Asia and South America, the figure is thought to be over 30 percent of the medicines on the market.
These medicines frequently do not contain the necessary active ingredients, or may contain harmful components. Counterfeit medicines not only infringe intellectual property rights; they represent a serious threat to health and, in many instances, life. “The battle against counterfeit products is being fought for the good of both patients and pharmaceutical companies,” Köstlin emphasizes.
Bayer is one of the founding members of the European Alliance for Access to Safe Medicines (EAASM), an organization which champions patients’ rights in this field. The Alliance increases awareness of the risks associated with counterfeit and low-quality medicines, highlights the shortcomings of current legislation and its implementation, and supports better protection for patients in Europe. At the same time, Arthur J. Higgins, Chairman of Bayer HealthCare’s Executive Committee, supports efforts to improve the safety of medicines in his function as President of the European Federation of Pharmaceutical Industries and Associations (EFPIA). One of the projects being pursued in this context is improved traceability of medicines. The EFPIA is planning to carry out a pilot study in a European country during 2008 which will test 2-D data matrix barcoding as a standard for all medicine packaging. This system, which is scheduled for rollout in Europe in the next few years, would enable products to be traced systematically throughout the supply chain.
These medicines frequently do not contain the necessary active ingredients, or may contain harmful components. Counterfeit medicines not only infringe intellectual property rights; they represent a serious threat to health and, in many instances, life. “The battle against counterfeit products is being fought for the good of both patients and pharmaceutical companies,” Köstlin emphasizes.
Bayer is one of the founding members of the European Alliance for Access to Safe Medicines (EAASM), an organization which champions patients’ rights in this field. The Alliance increases awareness of the risks associated with counterfeit and low-quality medicines, highlights the shortcomings of current legislation and its implementation, and supports better protection for patients in Europe. At the same time, Arthur J. Higgins, Chairman of Bayer HealthCare’s Executive Committee, supports efforts to improve the safety of medicines in his function as President of the European Federation of Pharmaceutical Industries and Associations (EFPIA). One of the projects being pursued in this context is improved traceability of medicines. The EFPIA is planning to carry out a pilot study in a European country during 2008 which will test 2-D data matrix barcoding as a standard for all medicine packaging. This system, which is scheduled for rollout in Europe in the next few years, would enable products to be traced systematically throughout the supply chain.
Integrated strategy
The company is currently developing an integrated health care provision strategy with the aim of expanding its activities even further in the future and coordinating them optimally. “We view our efforts to achieve sustainable health care as a central element of our corporate responsibility,” Köstlin remarks. “Accordingly, Bayer will continue to support achievement of the United Nations’ Development Goals in the future.”
Drug research at Bayer
In 2007 we at Bayer HealthCare spent €1.7 billion on research and development. In the course of integrating Schering into Bayer HealthCare’s Pharma segment we adapted the organization of our global pharmaceutical research and development to the changing business environment and implemented a new strategic alignment. Our drug discovery activities will focus in the future on the four growth areas oncology, cardiology, women’s health care and diagnostic imaging.
Increasing awareness of health risks
In addition to improved access to medicines, education plays a central role in global efforts to control disease. This is why Bayer has made health education a major element of its work in this field. In India, the country with the largest number of diabetic people in the world, Bayer HealthCare has partnered two companies and the international organization Project hope to create the India Diabetes Educator Project. This education and prevention program offers training for over 5,000 health care professionals with the aim of helping to improve the prevention and treatment of diabetes. Bayer also joined the Global Business Coalition on hiv/aids, Tuberculosis and Malaria (GBC) several years ago. And in China, for example, Bayer sponsors HIV education programs for company employees.
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| Dr. Gill Greer, Director-General of the International Planned Parenthood Federation (IPPF) |
The benefits of relatively low-cost interventions in good basic primary care, including good sexual and reproductive health, contraception services, information and supplies, are critical to development and the reduction of maternal mortality. Based on the world’s commitment to the Millennium Development Goals, we must drive policy and funding forward in order to deliver programs that can make a real difference to the lives of millions of women, men and young people.
Successful strengthening of national health systems requires an integrated approach, involving governments, civil society organizations and the corporate world. Our cooperation with Bayer HealthCare, one of our partners for many years, shows that multi-stakeholder collaboration works and helps to meet reproductive health needs in both developing and developed countries worldwide.
Looking towards the future, we would like pharmaceutical companies, including Bayer HealthCare, to further strengthen the holistic approach to global health care: Especially the understanding of diversity, including the needs of poor and marginalized people, is of great importance.
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