In checking my list of subjects for this week’s post, I saw a few of recent news items that I thought are relevant to the business of global health and worthy of noting. Here is what caught my attention:
Big Pharma’s Report Card
Two weeks ago, the Access to Medicines Foundation issued its biannual Index, a well-balanced overview and ranking of the efforts of twenty of the largest pharmaceutical companies in how they are meeting the world’s need for affordable and needed drugs and vaccines (Access to Meds). The Foundation rates a company on seven factors (management, public policy, R and D, pricing, patents, capability, and donations) and writes up a thorough summary of the activities of each. While all ranking systems are susceptible to hidden biases, the Foundation’s methodology seems to me to be comprehensive in that it is developed with input by a wide range of experts in global health and is reviewed and adjusted frequently (Methodology). Some of the highlights of the 2012 Index are: all the companies are improving with some creating departments with access responsibility, are making their goals and processes more transparent, and have products and pipelines that are meeting a greater number of needs. GlaxoSmithKline is still at the top with Johnson & Johnson and Sanofi improving to take the number two and three spots, respectively, surpassing two of the previous leaders, Merck and Gilead. Most useful for me are the individual company reports that provide details of a company’s global health R and D activities and therefore indicate partnering opportunities (e.g., Novo Nordisk report).
Did you ever wonder what are the world’s best drugs, at least in terms of the usefulness, safety, and affordability? Eric Palmer of the newsletter, FiercePharma, recently used data from IMS Health, the leading firm for tracking pharmaceutical sales, to compile a list of the twenty top-selling generic drugs, noting “Some of the meds on the list are not prescription drugs but everyday over-the-counter products that are safe, effective, cheap, easy to make, easy to transport, and easy to store and so likely to show up everywhere in the world” (FP special report). First on the list is pain-reliever, antipyretic paracetamol (acetominophen) at $6 billion in 2011 sales, apparently now favored over aspirin (no. 8) as the drug in the “take two and call in the morning” bromide. At number two at $3 billion in sales is ethinyl estradiol, used in most contraceptive formulations (Wikipedia article) which are clearly popular through out the world. Not surprisingly, two on the list are anti-cholesterol drugs (atorvastatin and simvastatin) and two are antibiotics (amoxicillin and clavulanic acid), all selling at $1.5 billion or more each. Rounding out the twenty are an anti-acid (omeprazole), blood pressure controller (amlodipine), an opioid (fentanyl), anti-inflammatory (diclofenac), and anti-diabetic (metformin), also all selling at more that $1.5 billion each year. One take-home lesson is that the market is working in creating cheap and (mostly) effective drugs for a wide range of aliments. The take-home for global health is that these are the drugs that should be considered essential by all public health agencies and there are business opportunities in improving their use (better diagnostics, compliance tools, formulations) and availability (distribution and sales).
Biggest Investor in Private Health Care in the Developing World
If you manage a life sciences company in an emerging economy country and need funding, skip the local bank and try the International Finance Corporation, a division of the World Bank that evidently has invested $450 million in life sciences companies over the past 10 years (IFC life science investment). In addition to investing in established companies such as drug manufacturers, hospital and diagnostic chains, and drug distributors, the IFC invests in “innovative companies aiming to increase product access through research and development or new product development using a viable and sustainable business mode” and “private equity funds investing in early- or later-stage development projects where there are technical risks, but where success could lead to significant development impact in the fight against diseases” (IFC Approach). Sounds good but the IFC investments are primarily as debt or equity, meaning the investee needs to have some assets and/or revenue to qualify, and I could find few details on how to apply and terms. There are two business contacts listed though. I also found a guide put out by the IFC that may be helpful for startups looking to sell into emerging market health care systems and needing to know the bumps (IFC Guide).