More Rigorous Evidence Needed on Pharma Access Programs
Global pharmaceutical companies have increasingly established programs to improve access to medicines in low- and middle-income countries, but efforts to evaluate the impact of such initiatives are inadequate, School of Public Health researchers say in a new report.
Writing in the journal Health Affairs, an SPH team reviewed the initiatives of 21 biopharmaceutical companies to assess how they evaluated and reported on the impact of their own access-to-medicines (AtM) programs. While the companies frequently claimed that their initiatives had positive impacts, the researchers found published evaluations for just 7 out of more than 100 AtM initiatives—and nearly all of them were of low or very low methodological quality.
“It is clear that the biopharmaceutical industry has increased its commitment to improving access to medicines in low- and middle-income countries,” wrote the research team, led by Peter Rockers, assistant professor of global health. “However, companies should do more to generate high-quality evidence on their initiatives, and the global health community should do more to assist the developing of evidence about the initiatives.”
The report identified 120 different programs, most of which used a medicine donation strategy (57 programs) or a price reduction strategy (53 programs) to increase access to medicines. That number grew from just 17 programs in 2000, as the industry responded to efforts by the United Nations and other agencies to improve access.
But while companies made “claims of impact” for 70 of the 120 programs, the research team found published evaluations for only seven, or 6 percent, of the initiatives. And nearly all of those evaluations were of low quality, with most lacking baseline data and a control group.
Commenting on the study’s findings, co-author Veronika Wirtz, associate professor of global health, said, “Many claims have been made as to the impact of access to medicine initiatives, but very few rigorous evaluations have been conducted and published. More transparent and inclusive strategies to evaluate these initiatives are clearly desirable.”
Study senior author Richard Laing, professor of global health, said the research “informed our current evaluation of Access Accelerated, a partnership to improve non-communicable disease care in low- and lower-middle-income countries.” Laing and Rockers are leading an evaluation of Access Accelerated, a first-of-its-kind global partnership between the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), the World Bank, and the Union for International Cancer Control.
Other co-authors on the study include: Chukwuemeka Umeh, formerly a research assistant in global health; and Preethi Swamy, formerly a research assistant at the School of Medicine.