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Access to healthcare and medicines in times of crisis
Médecins du monde – Doctors of the World International Network
Céline Grillon – 01/07/2015 S&D hearing on access to healthcare
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Doctors of the World – who we are & what we do
 an independent international movement working across the world (82
countries), both at home (180 programmes) and abroad (175 programmes)
 171 programmes across the EU: asylum seekers, undocumented
migrants, homeless people, Roma communities, elderly, destitute EU
citizens or nationals, people who use drugs, sex workers
 harm reduction attitude transversally present across all (inter)national
programs: adapting programs to the people’s needs, empowerment &
service user participation
 medical & social service delivery – data collection on persons not
described in official statistics – social change through empowerment &
advocacy
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Access to healthcare for
people facing multiple health
vulnerabilities
Obstacles in access to care for children and
pregnant women in Europe
65,5% of children were not vaccinated against mumps,
measles and rubella
54% of pregnant women had no antenatal care prior to
consulting MdM. Among them, 58% came to receive
care too late, after the 12th week of pregnancy.
63% of the people seen in Europe had no healthcare
coverage, mainly due to restrictive laws
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Access to medicine – the example of HCV new drugs
 185 million people across the world infected with HCV– risk of life-threatening cirrhosis
and cancer : 700 000 deaths annually
 Direct-Acting Antiviral Agents (DAA) are a real breakthrough in HCV treatment with
cure rates >90%
 Wide access would allow HCV eradication but…
Price
/12-week course
Sofosbuvir
(SOVALDI®)
Sofosbuvir+Ledipasvir
(HARVONI®)
USA
UK
France
Germany
Switzerland
Spain
84,000 USD
£34,983
41,000 €
43,500 €
94,500 USD
£38,980
46,000 €
23,587 €
60,000 €
33,000 €
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Exorbitant DAA prices
 Unethical price setting based on the damage a drug can prevent instead of
transparency in R&D costs and traceability of public funding of research
 Lead to treatment rationing – unethical and ineffective from a public health perspective
 Endanger public health systems – cost effective does not mean affordable : high
budgetary impact on European national public health systems in the context of austerity and
budgetary restrictions
 02/2015 – MdM opposed the patent on sofosbuvir at the European Patent Office
(along with 9 other opponents). Other (successful) patent oppositions in India and China +
Argentina, Brazil, Russia and Ukraine ongoing.
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Cost burden of new DAAs prices
for national health systems
€ billion
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cost of providing
SOVALDI® to all HCV
patients in France
Annual budget of
Parisian public
hospitals (2013)
French public health
insurance deficit (2013)
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Patents allow companies to keep prices artificially high
Prices of the first-line combination of stavudine (d4T), lamivudine (3TC),
and nevirapine (NVP) from 2000 to 2006
Médecins Sans Frontières, Untangling the web of antiretroviral price reduction 14th Edition July 2011, utw.msfaccess.org
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Pricing strategies
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Pooled procurement and/or pooled negotiation
Public pricing
Payback taxes
Parallel import
Compulsory licensing, a public health safeguard to overcome
patent barriers
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The result of a broken system
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High prices supposed to finance medical R&D but…
» Lack of transparency concerning R&D costs
» Investment in R&D vs marketing costs, benefit margins, fines &
legal costs, etc.
» No traceability nor conditionality of public investment in R&D
There is a need to promote a new biomedical R&D model by :
 supporting alternative models of financing R&D
 ensuring public R&D funding results in suitable and affordable
medicines
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Thank you!
[email protected]