Over the last 20 years, Axios has been at the forefront of market access. Here we share a few of the insights we've learned along the way.
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 anti-retroviral 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 largescale 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.