An interview with Michelle Erwee, Global Head, Access to Medicines, Takeda on improving access to medicines.
It is estimated that over 30% of the world’s population does not have regular access to essential medicines. The ability to access affordable, high-quality essential medicines is crucial to lowering healthcare costs and enhancing population health across the globe. This access is a critical issue that low- and middle-incomed countries continue to face.
With advances in science and technology, we are now able to change the way we deliver medications and vaccines, ensuring that no one is left behind. In this interview, we speak to Michelle Erwee, Global Head, Access to Medicines at Takeda, to find out more about the challenges low- and middle-incomed countries face in improving access to medical care and how Takeda is collaborating with organisations to provide support to underserved populations.
1. What are some challenges faced by low- and middle-incomed countries when it comes to improving access to essential medicines?
Low- and middle-income countries (LMICs) encounter a range of access obstacles that are often complex and interconnected. While no one country has the same set of challenges, we have developed an approach based on assessing the specific needs of a healthcare system in order to build programs that aim to deliver sustainable, equitable access to medicines.
Some common challenges we find include gaps in disease awareness, capacity within the healthcare system to diagnose and treat patients, the affordability of medicines, infrastructure and supply chain constraints, and regulatory barriers. Each of these challenges are barriers that pose significant threats to the timely delivery of medicines and care.
At Takeda, we recognise the urgency of these challenges and are committed to collaborating with governments, NGOs, healthcare providers, and other stakeholders to accelerate equitable access to medicines and vaccines. We believe that a comprehensive approach involving policy reforms, capability building, research and development partnerships, and investment in healthcare infrastructure can contribute to meaningful improvements in access to essential medicines.
We’re actively fostering innovation throughout our business to provide more customised access solutions for the medications and vaccines we develop. It’s all about finding new avenues and adapting our strategies to bridge the gap and ensure that no one is left behind in receiving the medical support they need.
2. How does the lack of access to medicine affect individuals, society, and organisations?
The lack of access to essential medicines has far-reaching consequences, affecting not only individuals but also society as a whole and the organisations that support it.
For individuals, it can directly compromise health outcomes, increase suffering, and diminish quality of life. Without timely and appropriate treatment, preventable diseases can escalate, leading to higher mortality rates and a greater burden of illness. For chronic conditions, it can result in rapid and unnecessary deterioration of health, bringing with it psychological and emotional ramifications that can affect individuals’ mental well-being.
In terms of the wider societal impact, higher disease prevalence and untreated health issues can strain healthcare systems, leading to increased healthcare costs, overwhelmed medical facilities, and reduced workforce productivity. Moreover, a population grappling with poor health can impede overall economic development and social progress, perpetuating a cycle of poverty and inequality.
Our efforts don’t stop at getting medicines to those who need them. They extend across the patient’s journey. From creating awareness, enabling accurate diagnoses, all the way to delivering treatment, there are many challenges that individuals and the wider society face. To effectively drive sustainable change, it is important to look beyond numbers to actual, real-world impact. And you have to be willing to play the long game.
3. Takeda Pharmaceuticals aims to broaden sustainable access to medicines through collaborations across public and private sectors. What are some examples of successful partnerships that Takeda has established to address these barriers?
As I mentioned, we know that the challenges faced in one market are very different from those that may be experienced in another healthcare system. What is common to nearly all successful partnership programs, however, is that they are sustainable, integrated into local healthcare systems, and address local needs.
To cite one example, our signature Blueprint for Innovative Healthcare Access Initiative, launched in Meru County, Kenya, as a pilot project in 2019, with the aim of increasing survival and improving the quality of life for patients battling noncommunicable diseases (NCDs) such as cancer, diabetes, and hypertension, demonstrates this approach in action.
From the start, the initiative sought to work with partners to provide local solutions that addressed local needs, enhanced existing capacities, and ensured continuity and sustainable impact.
Central to this was our work with Innovations in Healthcare (IiH), a not-for-profit organisation co-founded by Duke University, McKinsey & Company, and the World Economic Forum, to develop and apply an open-source impact framework. This framework supports continuous feedback, engagement and measurement, ensuring that we were all optimising the impact on both the patient and the broader health care system as a result of this initiative.
Jointly, we created the Access to Health Guidebook and Framework to address the need that we identified from our other global initiatives for a reliable and consistent measurement tool that could be applied universally to Access to Medicines initiatives.
In the three years that the project ran, together with our partners, we trained 3,300 healthcare professionals and volunteers, screened 150,000 patients, referred 10,00 patients to care, and reached over 365,000 community members through awareness-raising campaigns.
Moreover, through our holistic approach, we managed to decrease the out-of-stock inventory of NCD medicines by 35%, start a population-based cancer registry, and build an oncology curriculum that can be incorporated into existing healthcare training.
Seeing the impact that Blueprint had in Kenya, we moved to scale the approach across sub-Saharan Africa, including Rwanda, Uganda, Tanzania, Nigeria, and South Africa, and are now implementing the approach in Egypt and select LMICs across South-East Asia.
Beyond our Blueprint program, we have also pioneered innovative affordability Programs such as our Patient Assistance Programs (PAPs), which provide tailored financial assistance based on each patient’s unique situation. This is all done in partnership with other funding partners, including both government and non-government organisations. Since launching these means-tested programs in 2017, we have supported more than 5,700 patients in 18 countries and territories.
4. The affordability of medicines is a significant issue in lowand middle-incomed countries. Could you tell us more about Takeda’s tiered pricing and Patient Assistance Programs and how they work to ensure that even low-cost generic products do not become a financial burden for these populations?
We’re committed to ensuring systemic and financial constraints do not stand in the way of a patient’s access to innovative medicines and vaccines. Ultimately, our aim is clear: to make quality healthcare a reality for everyone, regardless of their economic circumstances. There are two main ways we do that:
Takeda deploys an innovative tiered pricing approach to provide affordable medicines in different countries, taking into account local economic conditions. This helps us ensure that local prices are based on a country’s specific level of economic development and the maturity of its health system.
Affordability-based Patient Assistance Programs
We recognise that even after our tiered pricing approach has been implemented, financial challenges still remain for many patients due to inadequate private and public health insurance schemes, which result in out-of-pocket expenses that are often so high that lifesaving medicines remain out of reach.
For this reason, Takeda makes available affordability-based Patient Assistance Programs. These programs are designed to support patients who would otherwise be unable to afford their prescribed treatment. Through these programs, eligible patients can receive assistance in the form of reduced-cost or free medications for the full course of their recommended treatment.
5. Takeda is committed to improving access to healthcare in underserved communities. How does Takeda navigate its partnerships with its various stakeholders to ensure the long-term success of its programs?
We recognise that creating sustainable change requires collaboration among all stakeholders involved. As a result, our approach to navigating partnerships centres around several key principles, starting with a shared vision, a commitment to collecting and analysing data, and learning and adapting continuously.
Fundamentally, however, the long-term success of any program hinges on whether we can integrate into existing healthcare ecosystems. It is counterproductive to barge ahead with what you might consider to be a great solution if it doesn’t work well within the existing context. That’s why we are very intentional about building and running programs that do not create parallel structures but rather embed themselves within the existing system and are capable of sustaining themselves independently over time.
Doing so effectively requires close coordination among local partners that have a keen awareness of the needs of the local healthcare system as well as a willingness to adapt and adjust to evolving conditions on the ground. [APBN]
This article was first published in the September & December 2023 print version of Asia-Pacific Biotech News.
About the Interviewee
Michelle Erwee is the Global Head of Access to Medicines at Takeda, where she has worked for the past 15 years in various leadership positions focused in accelerating access to the company’s medicines portfolio.