Pharmacoeconomics: Tool for Innovation and Access

A growing number of entities are embracing pharmacoeconomic studies to determine if the cost of a medication or medical device is justified in comparison with the benefits it brings, allowing them to make decisions considering the real value of a product. Despite the benefits that this field offers, the lack of communication between healthcare providers and companies is limiting the adoption of new medicines. 

“The pharmaceutical industry is increasingly performing pharmacoeconomic analysis prior to presenting a product to the market,” said Rafael Gual, Director General, CANIFARMA. “With pharmacoeconomics, we can know how many lives a product can save and how long it can prolong the patient's life.”

In the past few years, pharmacoeconomic studies have become more common in Mexico due to the pressure the health sector faces from limited budgets and changing reimbursement incentives, explained Sandra Sánchez-Oldenhage, President and CEO, PharmAdvice. These studies allow for the analysis of cost minimization, cost effectiveness, cost benefit and cost utility. “The main objective of pharmacoeconomics is not to provide less expensive products and services, but to improve health at a lower cost,” said Sánchez-Oldenhage. Its proper application offers useful information to decision makers regarding public health. It has also been leveraged for the R&D of new medicines, as the industry wants to develop products with greater efficacy and fewer side effects.

However, decision makers are sometimes discouraged by the fact that pharmacoeconomic analysis is mostly focused on the long term, while the need to save costs can be urgent. “The development of pharmacoeconomics in Latin America is incipient. This topic has been discussed during the past 20 years but more technical training is necessary to make decisions. When these cost-effectiveness conversations are held, it is thought that they only involve savings, but innovation always entails costs,” said Cristian Von Schulz Hausmann, Managing Director and General Manager, Merck.

Mexico spends US$1,300 per capita on healthcare, but only 50 percent of that amount is covered by the government while the rest is paid out of pocket. In other countries, healthcare investment per capita can rise up to US$5,000, with over 80 percent of it covered by the state. 

“Pharmacoeconomics should drive the conversation between countries to facilitate healthcare access and increase investment,” said Mauricio Rodríguez-Leal, Commercial Director, Apotex. Collaboration between countries should also be encouraged to improve and accelerate access to treatments, as it normally takes between 10 and 15 years to launch a new medication. 

Nonetheless, healthcare budgets will always be limited. “The constitution tells us about the right to health framed in laws that define the distribution of resources, funds and budgets that must be allocated for the provision of health services,” said Juan Luis Serrano, Partner Life Sciences, Sánchez Devanny. 

Moreover, the fragmentation of the Mexican health system and the lack of efficient regulatory processes are hampering the capabilities of pharmaceutical companies to accelerate access to the latest treatments. Although the system is not perfect, David De Pinho, Country Lead, Sanofi, said that there is no such thing as an ideal health system and that collaboration ought to be the focus of the industry. “We have to change our demanding tone to a more constructive one,” he said. 

Aside from a constructive dialogue, experts agree that patient centricity is essential for the health system to improve. “It has been demonstrated that taking the patient into account has a positive impact on the efficiency of the treatment, quality of life and costs,” said Sánchez-Oldenhage. 

Today, Zoe Robledo, Director General, IMSS, announced that IMSS-Bienestar would become a decentralized body, giving it technical autonomy and capabilities to expand throughout the entire country. “The change in IMSS-Bienestar is a hopeful message as its starting point is the constitutional right to health, which must be the same throughout the whole system,” said Serrano.

While the sector needs an independent entity to standardize regulation, the pharmacoeconomics field has limitations that must be addressed. Today the studies are done in a controlled, short-term context, which assumes and adherence of 100 percent. This is not a reflection of real life and real-life evidence is fundamental to offer an effective scientific and clinical judgment, explained Sánchez-Oldenhage.