Improving access to innovative medicines in emerging markets: evidence and diplomacy as alternatives to the unsustainable status quo

ABSTRACT

Introduction: Access to medicines is a substantial component of universal health coverage. However, the current dynamics between the innovative pharmaceuticals industry and governments in emerging markets are adversarial and may be counterproductive to sustainably increasing access to current and future patented medicines. Methods: This work is a review of public sources including white papers, news and peer-reviewed literature with a focus on mainstream approaches used by the pharmaceutical industry (such as unaffordable price premiums for innovative medicines) and governments (such as denial of intellectual property rights) to support their interests. We assess the need for consensus-based approaches as alternatives to the above policies and review country cases with supporting evidence. We also explore the implications of possible approaches on pharmaceutical policy in the context of global health diplomacy. The latter is a requirement for universal health coverage given the increasing power of state and non-state actors in emerging markets. Results: We conclude that evidence and due processes, through inclusive and transparent priority-setting mechanisms, offer a reconciliatory way forward for both parties. Value-based pricing, underpinned by Health Technology Assessment (HTA), could leverage global health diplomacy to set priorities and resolve the perhaps unsustainable status quo. HTA is itself a diplomatic, consensus building and evidence-based approach that can help diffuse the current tension, enhance mutual understanding and perhaps help strengthen (or even mend) the current model of product development. Discussion: Value-based pricing and HTA offer a potential priority setting mechanism that can serve as a transparent, non-adversarial platform for governments and the pharmaceutical industry to engage with each other and work towards enhancing access to medicines. Further quantitative research, exploring the impact of different policy-setting approaches by governments on medicine access using HTA, would strengthen this discourse.