The Healthcare Labyrinth Of Latin America
Understanding the complexity of the region is essential for any pharma company to flourish, says Jörg-Michael Rupp, Head of Latin America at Roche
The Latin America region has seen huge socioeconomic and demographic changes over the last few decades, with economies rising and falling, populations booming and climbing levels of inequality.
While demand for healthcare remains strong right across the region, the provision and quality varies from country to country, between city and countryside, and between government to private.
Understanding the complexity of the region is essential for any pharma company to flourish, says Jörg-Michael Rupp, Head of Latin America at Roche.
“We speak about Latin America as a region but it is very important to recognize that there are many different systems,” he says. “No one-size-fits-all approach will work. Every country is different and, within countries, each health system works differently. Also, while we must recognize the macroeconomics conditions of the past few years, in spite of these challenges, we are now seeing a positive trend in investment in healthcare.”
Looking across the region, Rupp sees four shared challenges affecting every country. The first is disease awareness, which remains low. “It is vital that we move towards the patient being self-aware and having access to the knowledge that allows them to safeguard and manage their own health. For example, in Brazil, 60% of women are not even aware of cervical cancer, even though the government offers programs and treatment for it.”
Alongside awareness is diagnosis. “Without a correct diagnosis, the patient cannot get to the right treatment. In oncology, patients are often diagnosed and subsequently treated at the very late stage of disease when the chance of success of the treatment is obviously lower than for patients who are diagnosed and treated at an earlier stage. An example, early breast cancer cure rates are close to 100% in certain types of the disease.”
Rupp’s third challenge is around healthcare capacity. “There remains a disparity between countries but also between the city – where there is usually good capacity – and more rural areas, where it can be very difficult for patients to find the right doctor and treatment centers.”
Funding is the fourth challenge. “If we compare the investments that countries are making in Latin America, where funding is approximately half government and half private, it is not in the same area as more advanced economies, so the region is behind at this stage,” says Rupp.
So, what role does he see for Roche and other pharma companies in tackling these challenges? “First of all, we need to recognize that researching and developing medicines and diagnostic tests that improve patients’ lives is the main contribution we make.
“However, at the same time, we’re very ambitious about access to our medicines, perhaps over-ambitious sometimes because our aim is for every person who needs our products to access and benefit from them. This vision drives our activities and our passion as we work with stakeholders to find solutions to these challenges,” he says.
Ensuring patient access remains a top priority requires those working on a new medicine to ask the right questions, say Rupp. “When we look at a new product and how we can bring it to patients, we have three questions that we ask the team to answer – what are the barriers that prevent access, how do we overcome them, and how do we make it sustainable? And that word, sustainable, is incredibly important as we look to who we can partner with.”
He cites an example in Peru. “We worked with many stakeholders – academia, doctors, patients – to run an awareness campaign in breast cancer. We started it and got the partners together and were very pleased to see that we reached 8 million patients in a very short period of time. This just shows you what can be done and the kind of magnitude that can be achieved when all the stakeholders come together. We may have started the conversation but, in the end, it is a joint achievement.”
As in other markets across the world, the issue of drug pricing is an important one in Latin America. “We recognize the role and responsibility we have in bringing medicines to market. If we get funding for a drug, we look at the many pricing schemes we apply across the world, such as pay-for-performance schedules, commercial agreements for specific pieces of the market, and we try to play our role in innovative price models. However, we’re just one player and it requires all stakeholders to want to pursue these models, so there are many factors at play, not just price.”
Rupp sees a strong role for pharma companies in helping healthcare systems put patients first. “Patient-centricity is a word that, for many players and stakeholders in the system, does not exist here in Latin America. We are certainly behind the developments in Europe and the US, however, we have seen the same trends over the past few years in patient getting access to more information and starting to play a more active role in their health and healthcare. As a company, we are working with patients and patient organization to better understand the individual journey each patient takes and how we can contribute to make treatment successful for every patient.”
With the economic indicators rising across the region, Rupp remains optimistic about the future. “Healthcare is a real focus for government across the region and we see that as a very positive signal. A recent report published by the Economist Intelligence Unit looking at cancer in Latin America highlighted some key areas where progress needs to be made.
“This report is important because not only does it help to prioritize this very important area of health, but it is the first time we have had a fact-based discussion across a number of parameters from prevention to early detection and budget. We need more of this kind of data so that everyone – academia, doctors, patients, providers and the pharmaceutical industry – can have a more open discussion. That’s where we would like to contribute as a company, as we’re absolutely clear that it’s a joint effort to address the challenges moving forward.”
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