With the increasing demand for high-cost, innovative medicines, low- and middle-income countries (LMICs) are facing even greater challenges when it comes to gaining access to life-saving treatments. Globally, spending on healthcare treatments is on the rise, increasing at a rate of 3-6% per year, with the highest volume growth occurring in Latin America, Asia, and Africa.1 With population growth, the increased incidence of non-communicable diseases and increasing life expectancy in LMICs, there is now an urgent need to improve access and affordability of drugs in these markets.
Access to affordable medicine is a fundamental human right, as specified by the Universal Declaration of Human Rights.2 However, for many individuals living in LMICs, this right is not attainable due to a lack of affordability or availability of essential medicines. According to a study of 72 high-, middle-, and low-income markets, there is currently an inverse relationship between country-income levels and drug prices, with lower-income countries paying higher relative prices for medicines compared to higher-income countries, which pay lower real prices.3 Several factors may explain inequitable drug pricing: higher-income countries may have greater leverage in price negotiations with drug companies and have more effective policies to control prices.
The question of drug affordability in LMICs varies across pharmaceutical companies, with some prioritising lower-income markets within their business models, whilst others falling short of providing access to these markets. In the most recent Access to Medicine Index, Novartis, GSK, and Sanofi have ranked as the top three companies working to improve access to medicines, vaccines, and diagnostics in low- and middle-income countries.4 These companies are focused on enhancing access governance, representation of populations from LMICs in research and development, and delivery and distribution to these markets to ensure their products get to those individuals in need. Despite the efforts of some companies to improve access, more needs to be done to ensure equitable pricing in LMICs.
Alternative pricing mechanisms are promising solutions to improve healthcare product pricing equity in LMICs. Some companies have adopted pricing strategies according to the ability of countries and individuals to pay. One example is Novartis, which has launched emerging market brands, that prices branded drugs significantly below the original brands for emerging markets.5 In Mexico, access to Novartis’ heart failure medication Entresto® has been expanded, providing significantly greater access to this life-saving treatment to patients. With these types of programmes, along with other strategies such as tiered pricing, payment caps, patient assistance programmes, access and affordability of essential treatments can be ensured in LMICs.
In conclusion, addressing inequities in pharmaceutical pricing and access in LMICs requires both innovative pricing strategies and a robust understanding of local market dynamics. While alternative pricing mechanisms such as tiered pricing and access programmes offer meaningful pathways to improve affordability, their successful implementation depends on having accurate, timely insights into pricing, reimbursement frameworks, and payer decision-making across diverse markets. High-quality pricing and reimbursement intelligence enables pharmaceutical companies to design sustainable access strategies, engage more effectively with governments and payers, and anticipate affordability constraints before products reach the market. By combining a commitment to equitable access with data-driven pricing and reimbursement approaches, stakeholders can better navigate the complexities of LMIC markets and help ensure that life-saving medicines reach the patients who need them most.
Equitable access starts with accurate intelligence. Discover how GPI’s pricing and reimbursement data helps pharma companies design access strategies that reach patients who need them most.
References
- United Nations. General Assembly. Universal declaration of human rights. Vol. 3381. Department of State, United States of America, 1949.
