Over the last 20 years, Axios has been at the forefront of market access. Here we share the latest news and insights shaping our thinking.
A Multicountry Survey of Patients and Physicians: Axios Publishes Study on Willingness to Pay for Medical treatments in Chronic Diseases
January 23, 2019
In order to effectively manage public health programs and new drug developments, it is now crucial to anticipate how the public will respond to the price of medical treatments in developed countries. Drug or service providers have to ensure that the price they set is both high enough to be able to sustain the drug supply and fund R&D activities for new treatments as well as low enough to allow the treatment to be broadly accessible and to achieve coverage goals. Now more than ever, there is a need for a more straightforward approach than adjusting prices by lowering or raising them in real-time to observe changes. Therefore, willingness to pay (WTP) techniques such as the contingent valuation approach are increasingly being applied to inform policy decisions in healthcare.
The objective of the study was to investigate factors influencing patients’ WTP and physicians’ views on the cost of therapy for two contrasted chronic diseases, chronic heart failure and psoriasis in ten developing countries. Results from the study indicate that disease-specific factors may affect WTP for treatment and should therefore be accounted for to support effective public health programs in developing countries.
Data gathered from surveys similar to those used in this study may provide important insight that can support the development of pricing models that achieve an optimum balance between program sustainability and patient access to quality care.
Read the full article published in the Journal of Comparative Effectiveness Research.
Ability and Willingness to Scale Access Initiatives Will Dictate the Future of Cancer in Developing Countries
January 9, 2019
Following the release of the Access to Medicines Index in November, Axios CEO Dr. Joseph Saba is featured in today’s edition of The Pharma Letter sharing his thoughts on how ability and willingness to scale access initiatives will dictate the future of access in developing countries.
In his op-ed, Dr. Saba points out that cancer products are included in the assessment for the first time and how it indicates that there is finally progression in how companies view access to medicine. He goes on to discuss how cancer access initiatives were found to be significantly limited in scope and how we can shift this reality to improve a cancer patient’s life during this critical turning point.
Click here to read the full report.
Healthcare Systems Aren’t Set Up to Efficiently Manage Chronic Diseases. How Can We Help?
July 16, 2018
Dr. Atul Gawande was recently announced as the new CEO of the yet-to-be named JPMorgan, Amazon, and Berkshire Hathaway joint venture. Gawande, a surgeon at Brigham and Women's Hospital in Boston, writer and professor, has long been an advocate for making healthcare systems smarter and more efficient. In a recent interview, he shared a story about his mother’s knee replacement surgery in the United States. In the course of three days, 66 different specialists or caretakers came into her hospital room – many giving contradictory advice.
As an industry, while technological and scientific innovation have surpassed our wildest dreams, our systems for healthcare delivery have lagged behind. Although to varying degrees, our experience has shown us that this is the case in most countries around the world.
Gawande has spent a large part of his career looking at how to improve healthcare facilities, and we are eager to hear what will come out of his most recent venture. However, as we look at the growing incidence of chronic diseases, which currently accounts for 71% of global deaths, we can’t forget a critical part of the puzzle.
Patients with chronic diseases require specialized care, costly long-term treatment and close follow-up, but what happens to patients once they leave the hospital?
Patients are on their own. Most receive limited to no follow-up to ensure that they are adhering to their prescribed care and treatment, and physicians are left without knowledge of what’s happening with their patient.
Patients diagnosed with the increasingly prevalent hepatitis C are a prime example of this. In 2016, only 13% of the 14 million people who were diagnosed with hepatitis C globally were able to start their prescribed treatment after diagnosis. We also see this with patients diagnosed with diabetes. At least 45% of patients with type 2 diabetes fail to achieve adequate glycemic control, with poor medication adherence being one of the major contributing factors. In developed countries, adherence to long-term treatment for chronic illnesses averages 50%. In developing countries, the rates are even lower.
This in turn limits the cost effectiveness of treatment (for patients and payers), and minimizes, if not nulls, its intended medical benefit.
How can we help health systems not only cope, but evolve to meet the needs of patients with chronic diseases most effectively? From a systematic perspective, adherence and disease management support is the common denominator. We also have to start thinking about Real World Data (RWD) differently.
Best Practices for Patient Assistance Programs in Thailand: Axios Shares their Insights at the DKSH Client Engagement Forum
July 10, 2018
The Axios team shared their insights on Patient Assistance Program (PAP) best practices for pharmaceutical companies in Thailand during the DKSH Client Engagement Forum in Bangkok on July 5th, 2018.
Presented by Roshel Jayasundera, Global Head of Consulting at Axios, the forum addressed key topics relating to patient access to healthcare in Thailand. Some of the issues discussed were potential patient access and support solutions, as well as key considerations for PAP design and implementation, including:
1. Utilize access models that are both financially sustainable for pharmaceutical companies and support improved patient outcomes. To be sustainable, access models should aim to be financially sustainable for companies by not negatively affecting their bottom line, allow patients at all income levels to share the cost burden and consider the patient’s full treatment plan. You can read more about some of these models here.
2. Willingness to pay and prescribe is key. Market penetration will be limited if willingness to pay and prescribe aren’t there, regardless of discounts provided. It’s important to inform physicians on the value of the program-supported medication and complement market access efforts with value proposition and education strategies where willingness is low.
3. Compliance is paramount. Understand the difference between working with third parties versus using distributors or sales forces to avoid conflicts of interest.
4. Engage physicians in a constructive manner. Make the process simple, ask for their input and explain the value of the program for them and their patients.
5. Conduct strategic reviews. Monitor progress along the way so companies can course correct as needed and see how actions are affecting the uptake of the program.
The audience, which consisted of more than 60 members of leading pharmaceutical and medical companies in Thailand, also had a chance to share their specific needs in the market and discuss solutions.
The forum was hosted by DKSH, a leading market expansion services group and Axios’ official distribution partner in Asia.
Axios Signs MoU with the UAE Ministry of Health and Prevention to Support Patient Access to Treatment
July 1, 2018
Axios has signed a Memorandum of Understanding (MoU) with The UAE Ministry of Health and Prevention, Novartis Pharmaceuticals and Eli Lilly to increase financial support to patients, in partnership with registered charity organizations in the country.
Under the MoU, support will be provided to 3,000+ patients living with a range of conditions, including psoriasis, multiple sclerosis, chronic asthma, retinal disorders, blood diseases, malignant tumors, and myocardial infarctions.
The agreement is part of the "Year of Zayed" initiative, a year-long commemoration to mark 100 years since the birth of UAE's Founding Father, the late Sheikh Zayed bin Sultan Al Nahyan. Discussions are underway to include more companies.
Axios Signs New MOU in Saudi Arabia: Contributing to The Country’s 2030 Healthcare Access Plan
March 4, 2018
In March, Axios signed a Memorandum of Agreement with the Charitable Association for Rheumatic Diseases (CARD) to provide additional psycho-social and financial support to patients enrolled in select Axios-managed programs in Saudi Arabia. With the support of CARD, Axios will be able to reach more patients in the country and to further contribute to the health initiatives under KSA's Vision 2030. This is yet another milestone for Axios growing influence and commitment in the region.
Axios Celebrates 20 Years: CEO Speech during Anniversary Celebrations in Dubai, Bangkok and Singapore
October 19, 2017
In September, Axios celebrated its 20th anniversary with events in Dubai, Bangkok and Singapore. The events brought together more than 250 clients and partners that have played a critical role in advancing the healthcare access agenda around the world.
The below is an excerpt from co-founder and CEO Dr. Joseph Saba's speech:
"20 years ago, we founded Axios with a vision: to change the access to treatment paradigm by working with pharma companies, government and civil society.
I was an infectious disease physician working with the WHO and UNAIDS and responsible for improving access to HIV treatment in LMICs. It became clear to me that access was soon going to become a major issue for NCDs, and many other chronic diseases.
Many people, including a prominent Wall Street Journal healthcare reporter called me an ‘idealistic dreamer.’ I just recently had dinner with him and I am happy to be able to tell him that 20 years later, that dream has com true. Access to care and treatment has become a priority for companies, governments and civil societies, and we have changed the access mindset and paradigm. Through the 20 years, we shifted access from a goodwill gesture to a professional venture where financial sustainability, compliance, high standards of work are the norm to achieve high treatment outcomes for patients.
We couldn’t have succeeded without our clients, partners and friends, and your forward-looking nature and embrace of innovation: customizing treatment access to patient affordability to allow patients to receive their full course of treatment and truly maximize medical benefit. Access is no longer about giving the patient a treatment pack. It is about improving a patient’s medical condition.
The journey is not over. With you, we will continue to innovate and expand. We will provide 360 degrees integrated patient solutions ranging from affordability, to adherence, access to diagnosis, and disease awareness and management in a multisectorial environment. We will take access to the next level. We will continue our journey together so that when you think access, you think Axios."
2017 Emerging Markets Market Access Industry Pulse Survey Results
September 15, 2017
Healthcare spending is growing faster than GDP in many countries around the world. Not only are people living longer, but many are living longer with chronic diseases.
Increased pressure on government healthcare budgets, particularly in emerging markets and developing countries, are changing the overall healthcare landscape from one where governments solely carry the burden of responsibility, to one where patients and other payers are increasingly responsible for sharing the cost of treatment and other medical interventions.
As a result, the market access industry has evolved rapidly over the last decade. Axios has been at the forefront of this industry for the last 20 years and has pioneered access solutions to address the changing needs of the pharmaceutical industry and those of patients around the world since 1997.
To help shape the next generation of access solutions and ensure that they continue to deliver high returns to all stakeholders, Axios surveyed pharmaceutical company executives responsible for market access initiatives (with a particular focus on emerging markets). The survey intended to capture insights on the progress of the market access industry to date, as well as future growth areas.
Pricing: Pharma's Achilles Heel: Overcoming the Price War with Smart Market Access Best Practices
June 6, 2017
A recent Harvard Business Review article ‘How Pharma Companies Game the System to Keep Drugs Expensive’ suggests that pharmaceutical companies may be profiting at the expense of patients by creating barriers to healthy competition.
While media dissatisfaction with the price of pharmaceuticals is nothing new, the visibility of this issue has grown. Yet this same media coverage offers limited explanation and analysis of the complex dynamics that drive drug pricing.
The reality is complex. Not only must pharma recoup their R&D investments and marketing costs, but they are also accountable to their shareholders without whom no investment in innovation is possible. As imperfect as this model may be, compared to not-for-profit or government models, it has shown to be successful in driving rapid drug development for some of today’s most critical health problems.
That said, understanding why drugs are priced as they are doesn’t take away from the fact that there remains a significant gap between drug prices and patient affordability. Nowhere is that more true than in emerging markets and developing countries.
So why not just lower drug prices? When you consider that monthly treatment costs for some specialty medicines are in the thousands, how much would prices have to be lowered to make it accessible to the majority of the patient population? Even with 40-50% discounts in price via direct discounting or bonus schemes (like buy 1, get 1 free), few patients would still be able to pay for their full course of treatment.
What can be done to make inroads on this persistent problem? Read on for Axios' Market Access Planning Best Practices.
Impact of Dengue Outbreaks: PLOS Neglected Tropical Diseases: Axios Publishes Qualitative Study on Societal Impact of Dengue Outbreaks in Brazil
March 10, 2017
The global incidence of dengue has grown 30-fold in the last 50 years – about half of the world’s population is now at risk. Incidence of dengue in Brazil has frequently been high, and the number of cases in the country has at times represented as much as 60% of all reported dengue cases worldwide.
In 2015, Axios undertook a qualitative study in São Paulo and Rio de Janeiro, Brazil, which experienced outbreaks in 2015 and 2012 respectively, to understand the impact of a dengue outbreak on different stakeholders and explore their perceptions of control measures implemented by governmental authorities during outbreaks. The study also analyzed the challenges and implications of preventing future dengue outbreaks.
Face-to-face interviews were conducted with a total of forty physicians, nurses, hospital administrators, municipal government representatives, community members and leaders, school administrators, business leaders and vector control managers to capture their experiences during a dengue outbreak.
The study found that dengue outbreaks undermine medical, societal, economic and political stability in local communities. Among other factors, this was largely due to a rapid influx of patients into the healthcare system, the financial burden placed on municipal governments, and community dissatisfaction and disengagement with government outbreak prevention and control efforts.
The data reported in the study provides a significant description of the challenges that need to be surmounted during a dengue outbreak and provides useful insights from different stakeholder populations that could guide local authorities and government officials in planning, designing and implementing integrated public health initiatives aimed at minimizing the multi-level impact of the disease.
Read the full article published in PLOS Neglected Tropical Diseases.
Cost-Effectiveness Studies in the Middle East: Axios leads training on cost-effectiveness studies during Bayer Middle East’s annual forum on macular diseases
November 05, 2016
Axios delivered a training on the use, value and process for conducting a cost-effectiveness analysis at FOCUS 2016, Bayer Middle East’s annual forum on macular diseases on November 4th 2016 at the Westin Dubai Hotel.
Presented by Michael Antwi, Consultant at Axios International, the workshop was intended for ophthalmology experts with minimal prior experience conducting a cost-effectiveness analysis. The objective was to address the current lack of data and capacity among health care providers to conduct cost-effectiveness analyses by providing them with the tools to conduct simple analyses with their own datasets and demonstrate which treatment options may be more cost-effective.
Organized annually by Bayer Middle East, FOCUS is a forum that brings together renowned international and regional ophthalmologists to share their experiences and join forces to improve the treatment of retinal diseases in general and diabetic retinopathy (DR) in particular. Nearly 450 ophthalmology experts from over 14 countries discussed advances in treating DR, a complication of diabetes that can lead to vision impairment and blindness that affects nearly one-third of an estimated 422 million diabetics worldwide.
Best Practices in Implementing New Health Interventions: Axios Publishes Study on Experiences and Lessons Learned from 29 HPV Vaccination Programs in 19 Countries
October 18, 2016
Cervical cancer is the third most common cancer in women worldwide and is the greatest cause of age-weighted years of life lost in the developing world. HPV vaccination may help to reduce the incidence of cervical cancer. Through the Gardasil Access Program (GAP), HPV vaccines were provided at no cost to organizations and institutions in eligible low-resource countries to help institutions gain operational experience designing and implementing HPV vaccination programs. A study conducted by Axios, the managers of GAP, captured the experiences and insights of participating country programs and the findings were recently published in BMC Health Services Research.
The objective of the study was to identify barriers, obstacles and strategies, and to analyze key concerns and lessons learned with respect to the implementation of 29 HPV vaccination programs in 19 low and middle-income countries. Results from the study indicate that local organizations and institutions can implement successful HPV vaccination campaigns once adequate and adapted planning and resources that support information sharing, sensitization and mobilization are in place.
The data reported in the study provides lessons that may be applied to the development of public health programs and national HPV vaccination policies in low and middle-income countries.
Read the full article published in BMC Health Services Research.
USAID Awards Axios a $1.5 Million Task Order to Develop the Next Generation of the National Supply Chain Assessment (NSCA) Tool
August 17, 2016
USAID has awarded Axios International a new task order to update and pilot the next generation of the National Supply Chain Assessment (NSCA) tool, one of USAID’s primary tools to support the design of public health supply chain strategies in developing country contexts by measuring supply chain performance and capability.
As part of this three-year, $1.5 million task order, Axios, in partnership with Abt Associates, will revise and update the current NSCA methodology, related tools and reporting system. Axios will also pilot and train stakeholders on how to use the updated tool. Additional NSCA assessments and implementations will be conducted by Axios on an ongoing basis as required by USAID and other donor agencies.
This project is part of USAID's Global Health Supply Chain-Technical Assistance (GHSC-TA) contract, which was awarded to Axios in 2015. The goal of GHSC-TA is to improve the availability of health commodities worldwide.
Axios Conducts Assessment of Warehouses used to Store USAID-donated Commodities in Mozambique
August 10, 2016
Axios International, under subcontract to Chemonics International Inc., conducted a market survey and assessment of warehouses in Mozambique used to store and manage USAID-donated commodities, including Long Lasting Insecticide Treated Bed Nets (LLINs). The assessment is part of USAID's Global Health Supply Chain-Procurement and Supply Management (GHSC-PSM) project, which was awarded to Axios in 2015. The project aims to improve the availability of health commodities worldwide.
The warehouses included those owned and managed by the Ministry of Health through its Central de Medicamentos e Artigos Medicos (CMAM), as well warehouses rented by SCMS on behalf of CMAM and managed by CMAM, or in the case of the LLINs, co-managed by CMAM and SCMS. The purpose of the assessment was to assess warehouse conditions, identify needed upgrades and improvements, and to recommend suitable options for immediate, short and long-term actions for the warehouses in the Nampula, Beira, and Maputo provinces.
Click here to read the final warehouse assessment report.
Axios Signs MoU with the UAE Ministry of Health and Prevention to Increase Patient Access to Rheumatoid Arthritis Treatment
June 14, 2016
Axios has signed a Memorandum of Understanding (MoU) with the UAE’s Ministry of Health and Prevention and NewBridge Pharmaceuticals to launch an initiative to increase patient access to treatment for Rheumatoid Arthritis (RA). The program will support patients who are uninsured or facing reimbursement barriers for their RA treatment.
The MoU was signed at the Ministry in Dubai by Dr. Amin Hussain Al Amiri, Assistant Under-Secretary for Public Health Policy and Licensing Sector of the UAE's Ministry of Health and Prevention, Anas Nofal, Regional Operations Manager at Axios Gulf, and Dr. Joseph Hanein, CEO of NewBridge Pharmaceuticals.
Dr. Al Amiri said the signing of the MoU with Axios exemplifies the Ministry’s commitment to improve health services for all UAE residents in accordance with the best international practices.
Key Takeaways from the 2016 Economist Health Care in Asia Conference
March 23, 2016
The Economist’s Health Care in Asia forum took place in Singapore on March 17th. Titled "War on Cancer," speakers and attendees discussed the challenges of financing cancer control and examined cost-effective, results-driven strategies to manage the cancer burden in Asia.
Bangkok-based Program Manager Thanika Chuakunta shares her key takeaways from the forum on what is needed to move the needle on cancer control and treatment in the region:
1. Invest in Information Infrastructure. Information and communications technology (ICT) infrastructure is key for effective cancer control, as it is necessary to disseminate data across institutions within and between countries. By facilitating collaboration and sharing of treatment information and outcomes, ICT has the potential to improve the overall effectiveness of cancer care.
2. Improve Data Quality. Data collection systems in developing countries are often flawed, and registries do not always provide reliable data. Patient data should be documented systematically according to international standards so that this information can be shared with and utilized by international cancer control networks.
3. Invest in National Health Identifier Systems. The use of National Health Identifiers (NHIDs) will be an important development in emerging market health systems to better track patient outcomes and progress and to facilitate timely and accurate patient follow-up across sectors, while maintaining patient confidentiality. Furthermore, individual-level health information is needed to monitor and evaluate the effectiveness, efficiency, equity and acceptability of service provision at the facility, regional and national levels.
4. Use Technology to Reduce Treatment-Related Costs. The high cost of cancer care often leads to financial hardship for the patient and his or her family. Technologies that cut costs by allowing patients to play a greater role in their own care will be a key factor in minimizing the financial burden associated with cancer and other chronic disase treatments.
5. Invest in Prevention. The long-term benefits of investment in prevention efforts have been shown time and time again. Leaders must continue to look at healthcare solutions holistically, even with rising costs, in order to meet the prevention and treatment needs of the population. Key areas for investment include not only vaccination for diseases such as Hepatitis C and HPV, but also education programs that guide lifestyle choices (such as exercise habits and nutrition) and may decrease their chances of developing cancer.
6. Use Public Funds to Encourage Healthier Lifestyles. Fiscal policy and government incentives have been shown to be effective in decreasing behaviors that can increase the risk of cancer. For example, Taiwan’s tax on alcoholic beverages and tobacco effectively decreased the consumption of these products, leading to a decreased number of cancer patients. In turn, the funds collected were invested in improving cancer care.
7. Access to Treatment. The cost of cancer treatment is a critical barrier to access among many patients in the region. Collaboration between public and private entities is necessary to drive the development and implementation of alternative access mechanisms that lower the cost of cancer treatment for patients while lessening the burden on governments.
Overall, it was agreed that comprehensive solutions for cancer control must include both increased emphasis on prevention and investment in new treatments. Regarding the former, innovative methods for cancer prevention, which utilize both education and new technologies, will be critical to reducing the number of cancer patients in the future.
Stakeholder Engagement to Drive Impact: Axios Receives Award from Dubai Health Authority in Appreciation for its Work in Supporting Patients in the UAE
February 05, 2016
The Dubai Health Authority (DHA) presented Axios International’s UAE team with an award in appreciation for Axios’ work in supporting patients through its UAE-based Patient Assistance Programs. Axios received the award at an annual event hosted by the DHA to recognize key individuals and organizations who played a significant role in supporting patients in 2015. The event was attended by physicians, pharmacists, nurses, charities and private companies.
Axios currently manages a range of programs in the UAE, including the first shared-payment program in the region. These programs use innovative financing mechanisms to increase access to treatments for oncologic, neurologic, ophthalmologic, endocrinologic, hematologic and other chronic and infectious diseases. Axios also recently launched a nurse-support program designed to increase medication adherence and support patients in managing their conditions. Together, Axios’ UAE programs have reached more than 1,000 patients at nearly 100 hospitals across the UAE.
Axios Co-Sponsors Symposium on Scaling Up HIV/AIDS Supply Chains at ICASA Conference in Zimbabwe
November 30, 2015
Axios CEO Dr. Joseph Saba led a panel discussion on scaling up supply chain systems for HIV/AIDS commodities at The 18th International Conference on AIDS and STIs in Africa (ICASA) in Harare, Zimbabwe on 30 November 2015. The purpose of the discussion, titled “Closing the Gap: Scaling Up Supply Chain Systems for HIV/AIDS Commodities to Meet the 90-90-90 Goal,” was to share key considerations and innovative solutions for successful healthcare scale up in the region in order to reach the UNAIDS 90-90-90 goal – by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression. The symposium was co-sponsored by Axios International and Medical Access Uganda Limited (MAUL).
Participants in the discussion included Zachary Gwa, Country Director, Axios Foundation Nigeria, Dr. Rashid Settaala, Program Director, Medical Access Uganda Limited, Prof. Elly Katabira, Professor of Medicine, Makerere University, Morries Seru, Acting Commissioner for Pharmacy Division, Ministry of Health Uganda, Arvind Kanda, Vice President of HIV and Infectious Diseases Mylan Labs, Donald Coetzee, Africa Country Manager, Abbott Molecular Diagnostics and Luc Denys, Senior Director of Access Programs, Janssen/Tibotec.
Building on his work with the UNAIDS HIV Drug Access Initiative, through which he established one of the first HIV/AIDS antiretroviral drug access programs in Chile, Côte d’Ivoire, Uganda and Vietnam, and his experience launching a number of successful access programs for cancer and other chronic disease treatments in low and middle-income countries in partnership with governments and pharmaceutical companies, Dr. Saba identified cross-sector collaboration, local ownership and the development of innovative and locally-relevant solutions as vital to successful healthcare scale up in sub-Saharan Africa. To illustrate these points, Dr. Saba highlighted Axios’ unique supply chain management approach, including its direct-to-institution approach to commodity delivery, which has been successfully utilized in multiple large scale medication access and donation programs worldwide. Dr. Saba also stressed the importance of integrating supply chain systems within existing national systems to ensure sustainability.
Following Dr. Saba's remarks, Zachary Gwa shared case studies from Axios’ supply chain management experience in Nigeria working with USAID, the United Nations Population Fund (UNFPA), US Centers for Disease Control (CDC), UK Department for International Development (DFID) and the Global Fund, among others, and in various largescale access programs, including the Gardasil Access Program (GAP), Viramune Donation Program (VDP) and Glivec International Patient Assistance Program (GIPAP).
The 18th annual ICASA conference was attended by over 7,000 of the world’s leading scientists, policy makers, activists, people living with HIV/AIDS (PLWHA), government leaders and civil society representatives.