Access to Treatment: Asia
Abd Razak Muhammad
Malaysia
CML Horizons, May 2012
The Region: Asia Pacific
Just over 4.2 billion people
live in the Asia-Pacific
region in 2010,
constituting 61% of the
world’s population.
Source: United Nations Population Division.
World Population Prospects: The 2010
Revision.
Difference in
Culture
Food
Languages
Healthcare systems
Challenges in Access to Treatments
•
•
•
•
•
•
•
•
No reimbursement
Health authority says “too expensive” –
economic point
Patient burden in co-pay in long term treatment
Capped in budget for drug – waiting list
? Corruption ? Inefficient in being referred for
reimbursement
Drug is not approved
Logistic challenge
Generic version
Paths to Access to Treatment
•
•
•
•
•
•
•
•
Government funded - full, partial
Insurance coverage - with limitation
Employer support - full, partial
Industry program
Self funded
Clinical trial
Named patient donation - compassionate
No access ?
Imatinib Access - Case Example: Malaysia
GIPAP, 2002
Patient - Industry
MYPAP, 2007
NOA, 2012
All hospitals
Government – Industry
Financial status
MOH & MOE hospitals
Patient – Industry
Fixed access scheme
Private hospitals
Fixed access scheme
Employer coverage
Insurance coverage
Full self funded
Clinical trial
A Malaysian patient will
have access to Imatinib.
Malaysia: Successful Model
MOH
Excellence in
Patient Care,
including
treatment
access
Network of CML Advocate Groups
In Asia Pacific
Our dream comes true – Rising Sun
2012, 3rd RS
Malaysia
2010, 1st RS
Hong Kong
Novartis organized
35 delegates
2011, 2nd RS
Community-driven
Singapore
Multi-sponsors
Novartis organized
(Novartis, Ariad, Pfizer,
Stem Molecular
Diagnostics, printing
companies)
42 delegates
54 delegates
Known CML Patient Groups in AP
•
•
•
•
•
•
•
•
•
India – Friends of Max
Indonesia – ELGEKA
Malaysia – Max Family
Thailand – Thai CML Patient Group & MaxSmiles
Philippines – Touched by Max
Vietnam – Max’s Vie
Pakistan – KIRAN
Japan - IZUMI
China – New Sunshine
Rising Sun 2012
– Meeting at A Glance
30 March 2012 – 1 April 2012, Kuala Lumpur
> 50 delegates
• 2 sessions - CML related, with survey among
participated countries
• 1 session - Clinical trial
• 3 Capacity building & Advocacy
• 1 Country Best Practices Show & Tell
• Posters display
6 SCs : Anna Williamson, Zhengchen Liu, Rod Padua,
Dr Razak, Viji Venkatesh, Mei Ching Ong
SC: Try to know more about what we do not know
Survey
The Existing Standards of Treatment, Monitoring
and Other Support Systems
For CML Patients in the Asia Pacific Region
Aims:
Collect background information on
• current status of CML care and support system
available to patients
• challenges, experiences could be shared and
learned and some issues could possibly be
improved




Based on the best knowledge of participants
May not reflect accurate information
No statistical significance could be inferred
Findings only for basis of discussion
Countries participate – 13
• Australia
• China
• India
• Indonesia
• Japan
• Malaysia
• Pakistan
• Philippines
• Singapore
• Sri Lanka
• Taiwan
• Thailand
• Vietnam
SECTION A:
TREATMENT AVAILABILITY AND
ACCESSIBILITY
Results
 Hydroxyurea, Interferon and TKI (at least
one) are available in ALL countries
 Stem cell transplant is NOT AVAILABLE in
Indonesia and Sri Lanka
 Only Japan & Australia have all TKIs as
first line
How is CML oral therapy (TKI) made
available in your country?
7
fully funded program
3
partially-funded program
self-funded
9
•
•
Majority access through partially-funded program
Some patients in Thailand, Malaysia and Singapore
self-funded their TKIs
Which fully-funded drug access
program exists in your country?
GIPAP/NOA
1
1
2
2
government
8
non government
corporate + government
full insurance
• Most countries has GIPAP/NOA
• Sri Lanka and Vietnam has full funded government program
• Malaysia has corporate-government shared program
• Singapore has non government full funded program
• Singapore and Taiwan have full insurance reimbursement
Which partially-funded program exists
in your country?
2
4
3
corporate
government
5
non government
insurance
Almost all countries has a program that patient need to share
with either corporate, government, non government or insurance
company
Is 2nd generation TKI (other than Imatinib)
available in your country?
 2nd generation TKI is available in all
countries EXCEPT Sri Lanka
How do CML patients have access to
2nd generation TKI?
drug assisted access
7
1* 1#
5
4
program
government sponsored
non government
sponsored
corporate sponsored
clinical trial
• Majority access through clinical trial
• government sponsored in Japan, Thailand, Vietnam and
Australia
• *corporate sponsored in China
• # non government sponsored in Singapore
end of Sec A
Key Learning from Survey
• TKIs are available in most of the countries , however access
remains a big challenge
o financially (partial reimbursement)
o logistic difficulties (China, Indonesia, India)
• Thai CML Group managed to lobby government to include “social
security” patients in imatinib reimbursement
 letter writing
 group of patients made appointment with authority, work
with media
• Support from key physicians in getting government funding for
treatment access is equally as important as lobbying from patient
groups.
Thank You
Descargar

Slide 1