Navigating medicine access’ complex landscape in Southeast Asia

In an ideal world, the fundamental right to quality and affordable healthcare would be accessible to all, regardless of geographical location or timing. It is a vision that embodies equality, compassion, and the belief that every individual deserves the best possible medical care. However, despite significant advancements in the field of medicine, this ideal remains elusive.

These barriers, as we see it, can be rooted in various factors, such as financial limitations, geographical remoteness, or inadequate healthcare infrastructure. As a result, disparities persist, preventing individuals from receiving the timely and quality care they deserve.

The journey towards achieving universal access to healthcare is an ongoing endeavor. It requires collective efforts from governments, healthcare providers, organizations, and individuals alike.

In the Philippines, to address persistent challenges in providing quality and affordable medicine to underserved populations, the Philippine Medicines Policy for 2022-2030 was enacted as a roadmap focusing on sustainable access to essential medicines and reducing health-related out-of-pocket expenses.

In line with this initiative, the inaugural Access to Medicines Summit in 2022 united various stakeholders with a shared goal of ensuring accessibility in alignment with the 2030 Agenda for Sustainable Development.

Moving the discussion forward, this year, the Access to Medicines Summit 2024 last 6 to 7 February at the Diamond Hotel Philippines showcased best practices from across Southeast Asia, foster collaboration, develop blueprints, advocate for policy changes, and engage diverse stakeholders.

Themed "Building Bridges: A Blueprint for Collaborative and Innovative Access to Medicines," the summit sought to achieve equitable access by bringing together representatives from health groups, financing institutions, NGOs, government offices and pharmaceutical companies.

In Southeast Asia, the crucial link between medicine accessibility and public health equity is strained, adversely impacting health outcomes in countries such as Indonesia, Vietnam, Malaysia, and the Philippines.

A recent study identified key obstacles, including low government health spending, dependence on external funding, challenges in implementing social health insurance, healthcare access disparities, inadequate facilities, lack of information, education and awareness.

Beyond issues of underfunding and fragmented insurance schemes, there are notable barriers such as geographical inaccessibility, limited awareness, and the scarcity of medicines for rare diseases.

Governments in Malaysia, the Philippines, Indonesia, Vietnam, and Laos, despite their commendable efforts to support medicine and public health accessibility, face various circumstances that limit their ability to allocate a more substantial proportion of their total budgets to health.

This allocation challenge unfortunately may pose obstacles in achieving significant progress towards the noble goal of Universal Health Coverage which resulted in cost shifts to providers and patients, contributing to medical impoverishment.

Incomplete insurance coverage in some countries forces out-of-pocket payments, exacerbating financial burdens. Fragmented health insurance schemes and varying benefits across age and socioeconomic groups contribute to inequities.

Effective medicine distribution and accessibility within countries require enhancements to supply chain management, distribution networks, and overcoming logistical challenges. Additionally, addressing challenges in healthcare infrastructure and capacity, including research and development, is crucial for a comprehensive patient journey.

In the face of increasing incomes across the developing world, the challenge of affordability continues to cast a shadow over access to life-changing medicines. However, there is a beacon of hope that shines brightly on the horizon: national reimbursement programs. These programs hold the key to overcoming the affordability barrier, but they require time to fully mature.

For example, Takeda has taken upon itself to lead the way in bridging the affordability gap for registered therapies. Through its sustainable approach, the organization strives to ensure that no one is left behind when it comes to accessing the innovative medicines they need.

Vietnam, like many countries, faces the challenge of high healthcare costs, with health services accounting for an average of 60 to 70 percent of household income. This financial strain often places life-saving medicines beyond the reach of many individuals and families.

Recognizing the financial burden that often accompanies innovative treatment options, Takeda launched its first-ever Patient Assistance Program in Vietnam in January 2023, aiming to bridge the affordability gap for patients battling Hodgkin lymphoma, a rare cancer that affects the lymphatic system.

Takeda's PAP in Vietnam stands as a pioneering effort in the country. Unlike traditional approaches, Takeda's PAP takes a patient-centric approach, determining the support required on an individual basis.

This personalized approach guarantees that eligible patients can receive the complete course of treatment prescribed by their physicians, regardless of their financial circumstances.

Meanwhile, Takeda also has implemented a similar Patient Assistance Program in the Philippines, which has provided assistance to over 700 patients who would have otherwise been unable to afford the necessary treatment.

In the Philippines, the National Integrated Cancer Control Act Localization Summit, organized by the Cancer Warriors Foundation Inc. sought to address the cancer care delivery gap by fostering multi stakeholder and intersectoral alliances at selected project sites.

The two-day summit covered topics such as strategies for localizing the NICCA among Local Government Units, government strategies for managing cancer, introduction of the Philippine Cancer Center, and strategies employed by LGUs, health institutions, and development partners in managing cancer.

Addressing the challenges related to accessing medicines goes beyond financial considerations. While the affordability of medications is a crucial aspect, the broader perspective acknowledges the importance of raising awareness and providing education.