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 * Innovating for Health Equity: Takeda's Blueprint for Medicine Access in APAC
   with Dion Warren

INNOVATING FOR HEALTH EQUITY: TAKEDA'S BLUEPRINT FOR MEDICINE ACCESS IN APAC
WITH DION WARREN

04 March 2024 | Monday | Interview



--------------------------------------------------------------------------------

Inside Takeda Pharmaceuticals’ Strategy to Overcome Healthcare Disparities in
India and Southeast Asia



 

In an illuminating conversation with BioPharma APAC, Dion Warren, the Head of
Multi-Country Organization, India and Southeast Asia at Takeda Pharmaceuticals,
delves into the intricate challenges of medicine access within the diverse
landscapes of India and Southeast Asia. Warren highlights the stark disparities
in healthcare infrastructure and economic conditions that contribute to the
unequal access to critical medicines, especially for complex diseases like
lymphoma and rare metabolic disorders. He also shares insights from the recent
Access to Medicines Summit 2024 and Takeda's innovative approaches, including
Patient Assistance Programs (PAPs) and public-private partnerships, aimed at
enhancing healthcare systems and improving the availability of innovative
treatments in the region. With a steadfast commitment to collaboration and
sustainable access strategies, Warren discusses Takeda's plans to address these
challenges head-on, driven by a core motivation to improve patient outcomes
across Southeast Asia and beyond.

 
 

What specific challenges do India and Southeast Asian countries face in medicine
access, and how do they differ from other regions?

 

 

In India and Southeast Asia, access to essential medicines, especially complex
or innovative treatments for lymphoma, other oncology or specialty
gastroenterology and rare immunology or metabolic diseases pose unique
challenges due to a variety of factors. These factors include the diverse range
in healthcare system maturity, variation in economic wellbeing within each
country, the rural-urban divide, underdeveloped healthcare infrastructure, and
limited health insurance coverage. These obstacles hinder the pursuit of
diagnosis, treatment and universal health coverage and create barriers to proper
healthcare for individuals in low- and middle-income countries within the
region.

 

While countries such as Singapore is categorized a high-income status, others,
such as Indonesia, the Philippines or Vietnam are considered low- to middle
income nations. The economic disparities among these countries contribute to
gaps in healthcare services, including access to medicines. This situation is
further exacerbated by the higher costs of medications in comparison to the
average income of the population. In the Philippines, for example, costs for
cancer treatment can go beyond USD 17,000, with a large part of this being borne
by the patient – a feat that is only managed by a few. In addition, the
rural-urban divide poses a considerable challenge as well, since rural areas
often lack adequate healthcare infrastructure, including diagnosis, pharmacies
and healthcare facilities. Long travel distances and logistical challenges
further hinder the population’s ability to access the necessary medications and
healthcare, resulting in delays or even complete unavailability of life-saving
medicines.

 

Insufficient healthcare facilities, a shortage of trained healthcare
professionals, and inadequate distribution networks all contribute to the
challenges faced by many parts of the region. Countries such as India and others
have a shortage of healthcare facilities, especially in rural areas, where most
of the population resides. Additionally, while some countries have established
universal health coverage systems, others still struggle with lower levels of
health insurance coverage, leaving a substantial portion of the population
without adequate access to needed medicines as they may lack the financial means
to afford the necessary treatments and healthcare support.

 

Could you share key outcomes from the Access to Medicines Summit that impact
India and Southeast Asia?

 

 

Featuring the theme “Building Bridges – A Blueprint for Collaborative and
Innovative Access to Medicines”, the two-day Access to Medicines Summit 2024 was
a platform to engage various stakeholders and share best practices from across
the region, foster collaboration, develop blueprints and advocate for policy
changes. 

 

While partnerships remain key to bringing societal changes, the role of
healthcare system strengthening programs cannot be ignored. Developed to
identify and address barriers to access across the patient journey, programs to
strengthen the healthcare system itself continue to remain pivotal to ensuring
equitable access to medicines. As covered in multiple discussions during the
Summit, it was agreed across the board that successful programs should emphasize
collaboration, local relevance, sustainable integration into local healthcare
systems and effective impact measurement. With holistic assessments that support
the evolution of public healthcare systems and ongoing collaborations with
various healthcare stakeholders, we believe that sustainable equitable access to
medicines is attainable in Southeast Asia, India and beyond. 

 

What best practices has Takeda implemented to improve medicine access in India
and Southeast Asia?

 

 

The most effective and sustainable solution to close the affordability gap are
national reimbursement programs, however, they can take years to mature and
provide access. Innovative Patient Assistance Program (PAPs), on the other hand,
aim to provide eligible patients with more immediate access to innovative
treatments, improving their quality of life despite potential financial
limitations. For instance, Vietnam’s first PAP to bridge the affordability
barrier to innovative treatment options for Hodgkin lymphoma saw the enrolment
of 48 patients within one year, providing them with optimal treatment duration
and helping overcome challenging financial circumstances. Such programs have a
significant impact in countries like Vietnam and many countries in Southeast
Asia where household direct out-of-pocket health expenditure, as a share of the
total health expenditure can range anywhere from 50% to 70%. There are many
other examples of similar PAPs in Indonesia, the Philippines and rest of
Southeast Asia which face the same affordability challenges. These PAPs are an
effective approach to ensure patients have access to innovative treatments and
the complete course of treatment prescribed by their physicians, while the
country’s reimbursement pathway continues to be formalized to enable sustainable
access.

 

The second approach involves establishing public-private partnership to
strengthen health systems. No single entity can effectively act alone and have
the required impact given the large scale of the global healthcare challenge.
This is especially the case for Southeast Asian countries with fewer resources.
Engagement with local authorities and partners, such as Centers of Excellence,
referral networks and caregiver networks are critical to scale impact and unlock
barriers along the entire patient journey, from disease prevention, screening
and diagnosis to treatment and patient support. Thailand, for example, has
implemented a cost-sharing model to assess and determine how much financial
support a patient will need to complete their treatment course based on their
economic conditions. Importantly, this cost-sharing model also determines how
much of the cost will be covered by other parties, such as insurers,
pharmaceutical companies, and the government. In addition, it allows patients to
access their full course of required innovative treatment by splitting the cost
between several parties – something that is only possible when parties from the
wider ecosystem work together in partnership.

 

How crucial are international partnerships in enhancing healthcare in the
region?

 

 

Collaboration brings together diverse perspectives, expertise, and resources
that can be instrumental in addressing complex healthcare challenges. By
fostering international partnerships, we can leverage global knowledge and best
practices to drive innovation, enhance healthcare delivery, and expand access to
quality treatments and therapies.

 

In India and Southeast Asia, where healthcare systems vary across countries,
international partnerships enable us to bridge gaps, create synergies and
leverage expertise. These collaborations facilitate knowledge transfer, capacity
building, and the exchange of scientific advancements, ultimately benefiting
patients and healthcare professionals in the region.

 

These partnerships can extend beyond the pharmaceutical industry. Through
collaborations with governments, healthcare organizations, academia, and
non-governmental organizations, we can collectively address the evolving
healthcare needs in the region. Additionally, international partnerships promote
the sharing of regulatory frameworks and standards, which are essential for
ensuring patient safety and the quality of healthcare services and medicines. By
aligning efforts and working together, we can navigate regulatory complexities
and foster an environment that supports the development and access to innovative
therapies.

 

What innovative approaches is Takeda exploring to overcome economic and
infrastructure barriers in India and Southeast Asia?

 

 

To overcome the economic and infrastructure barriers in the region, we continue
to collaborate closely with governments and a diverse set of stakeholders within
the health care community to enable sustainable access to innovative treatments.

 

Take the PAP in Vietnam as an example: We worked with the Vietnamese Ministry of
Health and a diverse set of implementation partners to conduct needs-based
assessments of patients’ financial circumstances, allowing us to provide
tailored and flexible financial support for eligible patients with a medical
need. This has enabled eligible patients in Vietnam to access the complete
course of innovative treatment prescribed by their physicians, regardless of
their ability to pay, and receive the optimal treatment duration despite
financial situation.

 

Can you outline Takeda's plans to address medicine access in the region?

 

 

On improving access to medicines, we will continue to broaden access by working
at the local level to expand the breadth and depth of access through access and
innovative funding models including Patient Assistance Programs (PAPs), which
provide access to innovative treatments by determining support required on an
equitable patient-by-patient basis. 

 

We are also focused on forging local partnerships and shaping policies to help
strengthen health care systems for the future. An optimal way to ensure patients
have timely access to life-transforming medicines is by building trusted,
effective and sustainable local partnerships working for the same cause as no
single entity can be effective acting alone. Most importantly, for us, Access to
Medicines is an integral part of our business strategy as we mobilize resources
and expertise internal and external to Takeda with clear the clear goal on
creating sustainable access to innovative treatments and healthcare needed by
the patient community.

 

What motivates your focus on improving access to medicines in Southeast Asia?

 

 

As a company we are focused on improving people’s lives by researching,
developing and bringing to market new and better medicines and vaccines that
help to address the world’s most pressing health care needs. To us, access to
medicines is about better health – for patients everywhere, regardless of their
ability to pay. It’s about respecting our common human dignity and putting the
patient at the center of everything we do. That’s why our Access to Medicines
ambition is integral to our wider global and local business strategy, and we are
committed to deliver real impact for people on a sustainable basis who may
otherwise be facing a  lack of access to needed medicines. 

 

*****

 ASEAN< The State of Higher Education in Southeast Asia,
https://asean.org/book/the-state-of-higher-education-in-southeast-asia/ Accessed
January 2024

 Philippines Institute for Development Studies, High treatment costs a death
sentence for many PH cancer patients,
https://www.pids.gov.ph/details/news/in-the-news/high-treatment-costs-a-death-sentence-for-many-ph-cancer-patients#:~:text=In%20the%20Philippines%2C%20the%20cost,have%20cancer%20in%20this%20country%E2%80%A6



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