SINGAPORE – Asia's rapidly developing health care ecosystem should ease market access for pharmaceutical companies and drug access for patients, but communication and transparency remain a key challenge hindering development. Unless all stakeholders in the sector come together, drug costs will remain high, industry experts said at the BioPharma Asia Convention here.
"Market access is the greatest challenge for pharmaceutical companies expanding to Asia," said Joseph Mocanu, principal of life sciences and digital health at Oliver Wyman, Singapore. Oliver Wyman is a global management consulting firm.
At the heart of this challenge is a lack of communication.
It is common knowledge that efficient communication reduces both time cost and actual cost in dollar terms. When the left hand knows what the right hand is doing and vice versa, both can work better together to achieve common goals in an optimized way. But when it comes to the health care sector in Asia, the left hand still isn't talking to the right hand, said Devmanyu Singh, regional business development and sales manager at Roche Singapore, during a market access panel discussion.
Singh emphasized the need for pharmaceutical companies, medical practitioners, insurers, payers and policy-makers to communicate with each other more openly and more frequently.
"As it is now, even if pharmaceutical companies want to increase access, the pathways in each market aren't designed to help us achieve that," said Singh. "For example, sometimes we need to do a full-fledged clinical [phase] III trial all over again in the region in order to access the market, which is very costly."
Joan Collar, managing director at Marsh, Singapore, agrees. Marsh is a global insurance broker and risk management advisory.
"There is a breakdown in communication and in awareness. Even though the ecosystem is there and the resources and information are there, the parts and the components aren't talking to each other. There needs to be discussion on why market access hasn't improved and why things haven't moved, to shake things up," said Collar.
A LACK OF TRUST
One underlying issue among the many communication problems within Asia's health care ecosystem is mistrust.
"There is a lot of finger pointing, a lot of mistrust," said Collar. "Payers blame the insurance companies for not covering certain drugs and treatments; the insurance companies then blame the hospitals, who then blame the pharmaceutical companies, who then blame the regulatory system for low reimbursement."
There is a mistrust of data from pharmaceutical companies as well because the general public thinks they have wrong intentions, said Mocanu.
That lack of trust is driving up the cost of getting drugs to market in Asia, and consequently the price of drugs.
"The question is, how do you create urgency among policy makers to make the move and lower barriers?" said Mocanu.
According to Collar, the first step to solving this is to identify the key influencers that would drive the industry to have conversations. Having a neutral party to coordinate knowledge sharing would also be helpful.
But getting the different players in the sector to willingly share is a long shot.
"Drug costs takes up around 25 percent of health care costs, so clearly there is much more to consider. A lot also goes to administration and human resources, for example, and there is a lot of wastefulness where resources could have been better spent, but would the various departments want to disclose such information?" said Singh.
"Even in Roche, the medical part is completely separate from the commercial team, which can be problematic. If stakeholders don't come together to share with transparency about the costs, there can't be meaningful conversation," he added.
The good news is that technology is changing this stubborn gap, albeit slowly. Social media has strengthened the willingness to collaborate by giving a voice to advocacy groups and various stakeholders who previously had no platform to speak, such as patients with rare diseases.
"There has always been some discussion about this communication problem pertaining to drug access and market access, so this isn't a new issue that just came to light, but I think the eagerness to solve this has certainly changed because of technology," said Collar.