Think about Robert Kamau, a 37-year-old plumber in Nachu, a remote village in Kikuyu constituency in Kiambu County. His life is dependent on daily pills daily to manage blood pressure.
“The pills always make me feel tired and drowsy, yet my work is physical,” he says.
Kamau, like many other people in Kenya, relies on old formulations because newer, better working drugs with less side-effects, available in rich countries, are expensive and difficult to come by.
“It’s unfair,” he says.
Indeed, there’s now increased interest in what efforts pharmaceutical companies are making to ensure their products reach patients such as Kamau, wherever they are.
Access To Medicine Foundation, a Netherlands-based non-profit which has been tracking the activities of pharmaceutical companies over more than 15 years, has released a report showing the current approaches adopted by some of companies to measure and report patient reach.
The report, titled “Patient centricity: How is the pharma industry addressing patient reach?”, was released on Tuesday.
The Foundation assessed 20 major pharmaceutical companies, many of which have presence in Kenya.
The report shows that 19 of the 20 companies assessed use various ways to track the patients they reach with their essential medicines in Low- and Middle-income Countries, with the exception of the US-based AbbVie.
Pharmaceutical companies are nowadays facing mounting external pressure to demonstrate how they are reaching more patients globally, especially in LMICs, and they have made numerous public commitments to this goal.
Marijn Verhoef, the director of operations and research at the Access to Medicine Foundation, told The Star that the efforts by the companies have been somewhat uneven, indicating a need for a more consistent and comprehensive approach.
“Without clarity on the populations they are already serving, it becomes impossible to pinpoint the areas where access remains inadequate—where the real gaps in access to essential medicines persist,” he said.
The report indicates that most of the companies use sales volume as the primary measure of patient reach for product-focused activities.
Of the 42 approaches reported, 35 measure the reach of product access efforts. Sales volume divided by dosing assumptions is the main metric used in these calculations. However, some companies have started to include additional assumptions, such as patient adherence, indicating a shift towards more nuanced measurement frameworks that go beyond just tracking sales, the report indicates.
The report also indicates that patient reach approaches vary widely in product and country coverage.
While some companies focus their patient reach approaches on individual products, others assess reach across their entire product portfolios.
Patient reach numbers are also regularly published for most approaches. “Companies must demonstrate this commitment by publicly reporting their patient reach numbers, alongside explicit explanations of how these patient reach numbers are calculated,” Marijn told The Star.
Despite many commitments by the industry, only a few companies set ambitious goals to address high-burden diseases.
The World Health Organisation describes health inequities as the differences in health status or in the distribution of health resources between different population groups.
Experts say pharmaceutical companies are uniquely positioned to impact health equity.
However, Jayasree K. Iyer, CEO of AMF said the pharmaceutical industry is making ambitious commitments to reach more patients worldwide.
“However, this report reveals that there is still much work to be done in achieving meaningful impact and calls for urgent steps to ensure lifesaving products reach every patient, everywhere,” Jayasree said in a statement.
The current report comes ahead of the 2024 Access to Medicine Index will be published in November and will report on specific R&D for people living in LMICs, manufacturing and supply chain capacity building initiatives.
