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Best practice

R&D unit dedicated to adaptive R&D aims to improve efficacy, safety, access




Unique R&D unit dedicated to adapting existing medicines to meet the specific needs of people living in low- and middle-income countries.




To increase the range of medicines available to people living in low- and middle-income countries, for example, by adding new indications or making them easier to administer in low- resource settings.


Medicines or diagnostics may need small but crucial adaptations to make them suitable for use in resource-limited settings. For example, adapting a medicine so that it lasts longer at higher temperatures can increase the chances of it being used, particularly in remote places.

What makes this a best practice?
Novartis’ working group for adaptive R&D, established in 2016, is a best practice in adapting R&D for use in low- and middle-income countries. This dedicated research unit scrutinises whether the company’s existing medicines offer new opportunities for improved efficacy, safety and access in countries in scope of the Index. 
The working group is endorsed by Novartis’ highest level of company governance and has been incorporated into objectives for its Head of Global Drug Development. This working group spans multiple research teams and seeks to identify and activate opportunities in three main areas: reformulating existing medicines; expanding a drug’s scope of use and the range of people it can treat (for example, children and older patients); and researching new areas (such as genetic polymorphisms) to better adapt products. Periodically, the working group systematically reviews the company’s entire portfolio to identify these opportunities.

How is this best practice addressing local needs?
By using systematic portfolio reviews, the working group has already identified multiple opportunities to adapt existing medicines to meet the needs of patients of low- and middle-income countries. Since 2017, when a review took place, the group has initiated a number of R&D adaptations for countries in scope. These include development of an expanded indication for clofazimine (Lamprene®), an anti-leprosy drug, to treat multidrug-resistant tuberculosis and of a long-acting, solid dispersible formulation of the antimalarial drug lumefantrine (a component of Coartem®) that is child-friendly and taken once-daily.

This best practice builds on Novartis’ previous good record in adaptive R&D. In 2009, the company launched a dispersible form of artemether-lume-fantrine (Coartem® Dispersible) that it co-developed with the Medicines for Malaria Venture (MMV). Since this launch, an estimated 350 million treatments of this product have been delivered to 50 malaria-endemic countries.

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View our detailed overview of each company’s performance in the Index, including breakdowns of their product portfolios and R&D pipelines.

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