This document summarizes a presentation on UNITAID's use of market-based approaches to increase access to medicines for HIV/AIDS, tuberculosis, and malaria. It discusses UNITAID's role in catalyzing, creating, and fixing markets. The document also reviews UNITAID's success in lowering prices and expanding access to second-line HIV treatments. In comparison, it finds the tuberculosis drug market to be more fragmented and inefficient. It argues that middle-income countries, particularly the BRICS nations, need to take a leadership role in consolidating and reshaping the tuberculosis drug market to improve global access.
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Mackintosh presented on supply chains.
Unilife Corporation (NASDAQ:UNIS - News) is a U.S.-based developer, manufacturer and supplier of advanced drug delivery systems with state-of-the-art facilities in Pennsylvania. Established in 2002, Unilife works with pharmaceutical and biotechnology companies seeking innovative devices for use with their parenteral drugs and vaccines. Unilife has developed a broad, differentiated proprietary portfolio of its own injectable drug delivery products, including the Unifill® and Unitract® product lines of safety syringes with automatic, operator controlled needle retraction. Unifill represents the world's first prefilled syringe technology integrating safety within the primary drug container. The products are ideally positioned to help pharmaceutical companies maximize the lifecycle of their injectable drugs and enhance patient care. Unifill syringes, together with other devices that are part of the Unilife technology platform, can either be supplied to pharmaceutical customers ready for use, or customized to address the specific requirements of targeted novel drugs. For more information on Unilife, please visit www.unilife.com.
Since its founding in 1935, Morgan Stanley and its people have helped redefine the meaning of financial services. The firm has continually broken new ground in advising our clients on strategic transactions, in pioneering the global expansion of finance and capital markets, and in providing new opportunities for individual and institutional investors. Click below to see a timeline of Morgan Stanley's growth, which parallels the history of modern finance
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Mackintosh presented on supply chains.
Unilife Corporation (NASDAQ:UNIS - News) is a U.S.-based developer, manufacturer and supplier of advanced drug delivery systems with state-of-the-art facilities in Pennsylvania. Established in 2002, Unilife works with pharmaceutical and biotechnology companies seeking innovative devices for use with their parenteral drugs and vaccines. Unilife has developed a broad, differentiated proprietary portfolio of its own injectable drug delivery products, including the Unifill® and Unitract® product lines of safety syringes with automatic, operator controlled needle retraction. Unifill represents the world's first prefilled syringe technology integrating safety within the primary drug container. The products are ideally positioned to help pharmaceutical companies maximize the lifecycle of their injectable drugs and enhance patient care. Unifill syringes, together with other devices that are part of the Unilife technology platform, can either be supplied to pharmaceutical customers ready for use, or customized to address the specific requirements of targeted novel drugs. For more information on Unilife, please visit www.unilife.com.
Since its founding in 1935, Morgan Stanley and its people have helped redefine the meaning of financial services. The firm has continually broken new ground in advising our clients on strategic transactions, in pioneering the global expansion of finance and capital markets, and in providing new opportunities for individual and institutional investors. Click below to see a timeline of Morgan Stanley's growth, which parallels the history of modern finance
TUBERCULOSIS ACCESS ISSUES THE KEY CHALLENGES IN MDR-TBUNITAID
Dr Paul Nunn, Coordinator, TB Operations and Coordination, World Health Organization
UNITAID Technical Briefing 65th World Health Assembly, 21st May 2012
UNITAID's Brenda Waning Presentation at the UNITAID/UNAIDS/Medicines Patent Pool Side Event,
United Nations High Level Meeting on AIDS
New York
9 June, 2011
This presentation by Pradeep Mehta was made at the 2014 Global Forum on Competition (27-28 February) during the session on competition issues in the distribution of pharmaceuticals. Find out more at http://www.oecd.org/competition/globalforum
Merck: Global Health and Access to MedicinesTony Sebastian
This is a HBR case study analysis of Merck, the pharmaceutical company. Detailed analysis of the issues are given in the case like CAGR framework, PESTAL, SWOT etc
For the complete report, get in touch with us at : info@netscribes.com
Abstract:
Netscribes’ latest market research report titled Medical Devices Market in India 2014 captures the technologically driven aspect currently prevailing within the Indian healthcare sector. The booming Indian economy is also witnessing a tremendous surge in the domestic healthcare scenario which, in turn, is leading to perpetual demand for high quality medical products. The demand for high-end, quality devices is especially driven by the private healthcare sector in its efforts to provide sophisticated treatment to patients. However, India lags behind in manufacture of technologically advanced high-end medical equipment, and instead has to rely upon imports from multinationals with extensive service networks. On the other hand, the market for less cost intensive medical supplies and disposable equipment is dominated by domestic manufacturers.
Due to the industry’s dependence on imports, multinationals are showing interest in relocation of manufacturing facilities to India as well as in forging alliances with healthcare sector stakeholders in order to capture greater market share. This brings into focus a key role played by the government that involves taxation and import regulations. The government also takes up several initiatives for the benefit of the market.
Coverage
• Overview of the medical devices market in India and forecasted market size data over 2012 to 2018
• Market Segmentation of medical devices by types
• Overview of the medical devices market in India by types and forecasted market size data over 2012 to 2018
• Snapshot of market segmentation of medical equipment
New and Refurbished Medical Equipment
Regional Demand for Medical Equipment
• Export-import overview of medical devices, value of export-import over 2009-10 to 2012-13 and country-wise value of export-import for 2011-12 and 2012-13
• Qualitative analysis of market drivers, challenges, trends and regulatory measures taken by the government
• Overview of the government bodies and their responsibilities
• Analysis of the competitive landscape and detailed profiles of major players
Why Buy
• Get a clear understanding of the medical devices market in India, how it operates and the various stages of the value chain
• Understand the current market segmentation and future growth potential of the medical devices market in India till 2018 and plan strategies to gain from it
• Strategize marketing, market-entry, market expansion, and other business plans by understanding factors influencing growth in the market
• Understand your competitors’ business structures, strategies and prospects, and respond accordingly
• Make more informed business decisions with the help of insightful recommendations provided to succeed in the Indian medical devices market
Global in vitro diagnostics (ivd) market (technique, product, usability, appl...Allied Market Research
"In Vitro Diagnostics Market (Techniques, Product Type, Usability, Applications, End-Users, Geography) - Industry Analysis, Trends, Share, Opportunities and Forecast, 2013 - 2020," the global In Vitro Diagnostics market has a potential to reach $74.46 billion by 2020 with North America being the largest regional market. North America is forecast to reach $30.1 billion by 2020 growing at a CAGR of 4.02% during 2014-2020. Asia-Pacific is forecast to be the fastest growing market and is expected to grow at a CAGR of 7.49% during the forecast period (from 2014 to 2020).
TUBERCULOSIS ACCESS ISSUES THE KEY CHALLENGES IN MDR-TBUNITAID
Dr Paul Nunn, Coordinator, TB Operations and Coordination, World Health Organization
UNITAID Technical Briefing 65th World Health Assembly, 21st May 2012
UNITAID's Brenda Waning Presentation at the UNITAID/UNAIDS/Medicines Patent Pool Side Event,
United Nations High Level Meeting on AIDS
New York
9 June, 2011
This presentation by Pradeep Mehta was made at the 2014 Global Forum on Competition (27-28 February) during the session on competition issues in the distribution of pharmaceuticals. Find out more at http://www.oecd.org/competition/globalforum
Merck: Global Health and Access to MedicinesTony Sebastian
This is a HBR case study analysis of Merck, the pharmaceutical company. Detailed analysis of the issues are given in the case like CAGR framework, PESTAL, SWOT etc
For the complete report, get in touch with us at : info@netscribes.com
Abstract:
Netscribes’ latest market research report titled Medical Devices Market in India 2014 captures the technologically driven aspect currently prevailing within the Indian healthcare sector. The booming Indian economy is also witnessing a tremendous surge in the domestic healthcare scenario which, in turn, is leading to perpetual demand for high quality medical products. The demand for high-end, quality devices is especially driven by the private healthcare sector in its efforts to provide sophisticated treatment to patients. However, India lags behind in manufacture of technologically advanced high-end medical equipment, and instead has to rely upon imports from multinationals with extensive service networks. On the other hand, the market for less cost intensive medical supplies and disposable equipment is dominated by domestic manufacturers.
Due to the industry’s dependence on imports, multinationals are showing interest in relocation of manufacturing facilities to India as well as in forging alliances with healthcare sector stakeholders in order to capture greater market share. This brings into focus a key role played by the government that involves taxation and import regulations. The government also takes up several initiatives for the benefit of the market.
Coverage
• Overview of the medical devices market in India and forecasted market size data over 2012 to 2018
• Market Segmentation of medical devices by types
• Overview of the medical devices market in India by types and forecasted market size data over 2012 to 2018
• Snapshot of market segmentation of medical equipment
New and Refurbished Medical Equipment
Regional Demand for Medical Equipment
• Export-import overview of medical devices, value of export-import over 2009-10 to 2012-13 and country-wise value of export-import for 2011-12 and 2012-13
• Qualitative analysis of market drivers, challenges, trends and regulatory measures taken by the government
• Overview of the government bodies and their responsibilities
• Analysis of the competitive landscape and detailed profiles of major players
Why Buy
• Get a clear understanding of the medical devices market in India, how it operates and the various stages of the value chain
• Understand the current market segmentation and future growth potential of the medical devices market in India till 2018 and plan strategies to gain from it
• Strategize marketing, market-entry, market expansion, and other business plans by understanding factors influencing growth in the market
• Understand your competitors’ business structures, strategies and prospects, and respond accordingly
• Make more informed business decisions with the help of insightful recommendations provided to succeed in the Indian medical devices market
Global in vitro diagnostics (ivd) market (technique, product, usability, appl...Allied Market Research
"In Vitro Diagnostics Market (Techniques, Product Type, Usability, Applications, End-Users, Geography) - Industry Analysis, Trends, Share, Opportunities and Forecast, 2013 - 2020," the global In Vitro Diagnostics market has a potential to reach $74.46 billion by 2020 with North America being the largest regional market. North America is forecast to reach $30.1 billion by 2020 growing at a CAGR of 4.02% during 2014-2020. Asia-Pacific is forecast to be the fastest growing market and is expected to grow at a CAGR of 7.49% during the forecast period (from 2014 to 2020).
Does Price Discrimination Have a Place in Pharmaceutical Pricing in Developin...Office of Health Economics
At iHEA 2013, OHE's Adrian Towse participated in a session on implementing differential pricing schemes. He discussed the role of price discrimination strategies, including the use of discounts, access programmes and risk sharing agreements in increasing the number of patients who can benefit from new medications in LMICs. Real life examples illustrated differential pricing schemes between and within countries and provided background for exploring feasibility—particularly about how options relying on confidentiality and negotiation compare with those based on collaborative international agreement about how price differentiation is developed and implemented.
Market Approaches for Innovation and AccessUNITAID
The Gilead Sciences Presentation during the session "Market Interventions for Innovation and Access", UN High Level Meeting on HIV/AIDS
New York, 9 June 2011
The Medicines Patent Pool Presentation during the session "Market Interventions for Innovation and Access", UN High Level Meeting on HIV/AIDS
New York, 9 June 2011
This report was presented to the 12th session of the Executive Board, on 9 June 2010. It contains the most recent data on the performance of Operations Unit, including an overview of the HIV/AIDS, malaria and tuberculosis portfolio.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MARKET-BASED APPROACHES FOR PUBLIC HEALTH IN THE GLOBALIZATION ERA
1. UNITAID
Briefing for Delegates to
the 65th World Health
Assembly
Market-based approaches
for public health
in the globalization era
Palais des Nations
Geneva, Switzerland
21 May 2012
Page 0
2. Agenda
1 UNITAID's Market Approach to Public Health
UNITAID's Success in Increasing Access to
2 2nd-line HIV Medicines: markets dominated
by donor funding
Challenges & Opportunities to Increase Access
3 to TB medicines: markets dominated by
middle-income country funding
Page 11
Slide
3. 1 2 3
How UNITAID intervenes in markets
UNITAID’s role depends upon the particular
circumstances in a given market:
• Market catalyst: identify and facilitate adoption and uptake
of new and/or superior public health products;
• Market creator: provide incentives for manufacturers to
produce otherwise unattractive products with low demand that
yield little profit but substantial public health benefit to those in
need; and
• Market “fixer”: address severe market inefficiencies (e.g.
grossly inaccurate demand forecasts and excessive
transaction costs) that contribute to low access to quality-
assured public health products.
Page 2
4. 1 2 3
UNITAID Market Impact Framework
• Begins and ends with identifying and addressing access problem
• Market interventions are merely tools to increase access
Case for intervention Pathway from market to public health impact
Public health Market
Innovative Sustainable
problem & shortcomings Public health
market market
commodity and their impact
intervention impact
access issues reasons
Benefit of a market approach:
Market impact (e.g., price reductions, improvements in
quality & formulation) from UNITAID interventions are accessible
to all purchasers, not just UNITAID's direct beneficiaries
Page 3 www.unitaid.eu
5. 1 2 3
UNITAID Results in 2nd-line HIV Market
450k in need
260k in
need 210k on ART
76k on 71k
ART UNITAID
2005 2010 2012
Price: $1500/person/year Price: <$500/person/year
Supply: <5 quality formulations, Supply: >20 formulations,
ARVs required refrigeration, ARVs are heat-stable,
no pediatric formulations, pediatric formulations,
2 manufacturers >9 manufacturers
Page 4
6. 1 2 3
Key factors in success of HIV 2nd-line
market evolution and increased access
• Donors provided majority of funds (Global Fund, PEPFAR, UNITAID)
• Similar donor requirements on procurement & quality policies
• Coordinated approach to price negotiation & price transparency
• Interventions to improve ARV process chemistry to reduce prices
• Efficient quantification & pooling of ARV demand
• Communication to suppliers about current & future needs
• Monitoring & reporting of supplier performance & API availability
• WHO guidelines simplified: recommend a few ARVs, regimens
– Most treatment provide by public sector that follows WHO guidelines
Result: Consolidated & efficient market where donors exert
strong market power to shape markets for maximum access
Page 5
7. 1 2 3
What's different about TB markets?
• Domestic funding ~87% of expected 2012 funding
• Procurement & quality policies differ dramatically across countries
• Little coordination on price negotiation & price transparency
• Few interventions to improve process chemistry to reduce prices
• Inefficient quantification of global TB medicine demand
• Poor communication to suppliers about what will be needed
• Little monitoring & reporting of non-donor supplier performance
• Private sector provides substantial treatment: regulation
challenges, may not follow WHO guidelines, poor adherence
Result: Fragmented & inefficient market where donors have little
market power; a few countries dominate in local & global markets
Page 6
8. 1 2 3
Private sector volumes of 1st-line TB Medicines
Size of private market, using first-line drugs
as a proxy • Private sector capacity to
India supply first-line drugs
Indonesia varies widely across
Philippines countries
Weighted average
Pakistan
China • Private sector supply
Thailand fosters MDR-TB through:
Russian Federation • non-standardized
Bangladesh dispensing of medicines,
Viet Nam irrational use of medicines,
South Africa of uncertain quality)
• patient loss to follow-up
0% 40% 80% 120%
% of all incident MDR-TB cases that can be treated by
first-line drugs in the private-sector market
Source: WHO Progress report 2011. Towards universal access to diagnosis and treatment of MDR- and XDR-TB by 2015.
Data from Wells W et al. Size and Usage Patterns of Private TB Markets in the High Burden Countries. 2011.
Page 7
9. 1 2 3
Trends in MDR-TB market evolution & access
440k in 440k in
need need Estimated treatment coverage (GLC only)
Estimated UNITAID coverage
45k
2005 2010 2012
Price: High, unaffordable prices Price: High prices ($>2,000/tx)
Supply: Few PQ formulations, Supply: Few PQ formulations,
Injectable medicine needed, Injectable medicine needed,
Lots of side effects, Lots of side effects,
Treatment of 18 months, Treatment of 18 months,
Few manufacturers, Few manufacturers,
Insecure API supply
Page 8
10. 1 2 3
Innovation & emerging opportunities in TB
Diagnosis Treatment
• 2 new MDR-TB Medicines in
2012-2013: TMC-207, OPC-
67683
• Global TB Alliance:
• New, shorter regimens
with existing medicines
GeneXpert: • New medicines & new
Revolutionized TB regimens: safer, cheaper
diagnosis
Page 9
11. Middle-Income Countries are Leading 1 2 3
TB Efforts & will Play Increasingly Important Roles (1)
• “Market anchors” through early adoption of new
technology & large scale purchases
– End of 2011, >50% of GeneXpert cartridges purchased by S. Africa
• Innovation & technology incubators
– GeneXpert fast followers likely to emerge from India or China
• Local pharmaceutical production
– Substantial production capacity for APIs & finished products
• Technology transfer
– Brazilian ARV tech transfer to Mozambique
• Government funding & service provision
– Brazil's commitment to free ARVs
Page 10
12. 1 2 3
Middle-Income Countries are Leading TB
Efforts & will Play Increasingly Important Roles (2)
• Regulatory efficiency & harmonization
– “Not a single regulator today can work meaningfully in isolation,” “The
future of medicines regulations is more in harmonisation, collaboration, and
network.” Lembit Rago at Brazilian Meeting on Regulation, May 2012
• Coordinated or pooled procurement
– Aggregate demand across multiple buyers & communicate to suppliers for
planning for medicines in low demand
• Information sharing
– Funding, product availability, quality, price, supplier performance,
guidelines
• Pharmacovigilance
– Careful monitoring & “protection” of new medicines & regimens
Page 11
13. 1 2 3
Summary & Conclusions
• Many donors & international organizations have recently adopted
market approaches to improve public health
– Most interventions leverage purchase power, policy conditions on funding,
guidelines & standards, and other tools to shape markets
• Donors are no longer the only source of leverage; middle-income
countries dominate TB markets
• BRICS have unique opportunity to define a common TB agenda
– Drive MDR-TB Scale-up: proper diagnosis, better medicines
– Opportunities for global leadership & improving country program efficiency
• Interventions in BRICS will have ripple effects in poorer
countries; fragmented TB market requires BRICS leadership to
consolidate and reshape for improved global access
• New paradigm must emerge where BRICS lead and work in
collaboration with donors who can represent the poorer countries
Page 12
14. 1 2 3
Thank you
Acknowledgements
• Janet Ginnard
Contact Information
• Brenda Waning:
waningb@unitaid.who.int
Page 13