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Innovative practice

Novartis Access uses portfolio approach to address affordability for products for non-communicable diseases

Aim:

To reach 20 million patients per year by 2020, supplying more than 5 billion tablets per year to these markets.

Model:

Portfolio of 15 on- and off-patent products for non-communicable diseases (NCDs) marketed to national governments, NGOs and other stakeholders in the public sector, for USD 1 per treatment per month, supported by capacity building.

Partners:

Local NGOs for specific capacity building aspects.

Scale-up:

To 3 additional countries within the period of analysis; from two in 2016.

Novartis Access focuses on making treatments for major chronic diseases both affordable and available in lower-income countries. In the healthcare industry, it represents a first, using a portfolio approach that covers 15 of the company’s medicines (including some that are protected under patent) that treat NCDs such as diabetes, respiratory illness, breast cancer and cardiovascular disease.

How does the Novartis Access model work?
Novartis Access offers access to this portfolio to governments, NGOs and other stakeholders in the public sector at a price of USD 1 per treatment per month. Novartis Access also incorporates capacity building activities. These include community awareness and community-level screening of non-communicable diseases and subsequent understanding metrics such as blood pressure and blood sugars. Through its implementing partner NGOs, it trains pathologists and laboratory technicians to increase capacity and quality of diagnostics for breast cancer, provide training on guidelines for diabetes, hypertension, asthma and heart disease.

A supply chain worker in Kenya checks the shipment of medicines from Novartis Access. ©Novartis

With each party that wants to buy medicines, Novartis negotiates the size of the basket (i.e., the number of treatments bought overall). This allows Novartis to focus on integrating its supply chain horizontally, coordinating the supply of multiple treatments to individual purchasers. One key benefit of the approach is that it gives governments the opportunity to buy medicines covering a range of common conditions at a subsidised price.

Novartis launched the Novartis Access portfolio in Kenya and Ethiopia in 2015, addressing the high prevalence of NCDs in these countries and aiming to expand access to treatment. Since launch, Novartis Access has delivered more than 800,000 treatments in these countries. Partnering with governments and NGOs, Novartis Access continues to create capacity and capability to deliver better outcomes for patients. Through 2017, for example, it expanded its activities to include awareness raising, improving diagnosis, healthcare worker training, supply chain integrity and distribution.

How has this business model been scaled-up?
Novartis is now preparing to roll out the initiative to new countries. During the period of analysis, in 2017, Novartis signed agreements with three further governments (Uganda, Rwanda and Pakistan). It is now in advanced discussions to offer Novartis Access to 10 more countries in Asia and Africa, and longer term it hopes to offer Novartis Access in 30 further countries, not only in Africa and Asia but also in Latin America and Europe. It has already filed 502 product submissions with health authorities in 24 countries, gaining 221 approvals to date. Novartis is measuring impact of this initiative in collaboration with Boston University.


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