The Max Foundation Cancerworld recently published an article by Ann Wagstaff titled Begging for imatinib: why do so many patients still lack access to this lifesaver? It highlights the challenges people living with CML face in accessing imatinib, a life-extending medicine that has been generic for many years. Here is our perspective on the story.
We have known for some time that most innovative drugs are not available in low-middle income countries (LMICs) and that patients needlessly suffer without treatment. The Max Foundation bridges this gap by developing access models in LMICs in collaboration with it partners to help patients in urgent need.
This article is important because it dispels common myths about access to innovative medicines after patient expiry in LMICs and underscores that availability of treatments does not by itself create access for patients. These myths prevent progress. By telling the story of one of the first orphan drugs in cancer and what took place when the originator lost patent exclusivity, the article highlights three critical lessons that we must consider when developing solutions:
- As orphan drugs loose patent protection, we cannot expect that generics will come to markets in LMICs; availability of generics by themselves does not solve the problem. All stakeholders, including the innovative companies that develop medicines, bear responsibility and must continue to collaborate to improve access for patients.
- High prices from the originator are not the only barrier to access for innovative medicines. Even when generics come to markets, especially in LMICs, they are still not affordable for most patients
- Further, even in cases where generics are affordable or reimbursed, weaknesses in health care systems as well as budgetary pressures experienced by local governments often prevent access.
To achieve access for all, we must put the patient first and act as a global community instead of pushing responsibility on one another. As a first step, we must agree on a definition of access meaning that it only exists when all patients are able to receive the right treatment and the right dose at the right time.
Only by putting the needs of patients’ first and working together as a community can we drive lasting changes that will deliver real solutions for patients in need.