With 2 billion people estimated to lack regular access to essential medicines, access cannot currently be described as equitable. Varied barriers include mostly different pricing practices, inadequate health systems and gaps in funding and regulation processes. Recognising that only a small number of patients in some low- and middle-income countries can afford its cancer medicines, Pfizer has worked with governments and other stakeholders to develop sophisticated patient assistance programmes (PAPs) that take into consideration all income levels.  

Pfizer exemplifies best practice in offering equitable solutions to patients living with cancer. It has implemented income-tailored solutions for two of its products: crizotinib (Xalkori®), which treats lung cancer, and palbociclib (Ibrance®), for the treatment of breast cancer. By developing a patient affordability model, the company has increased access to these self-administered oncology products in certain countries. 

Philippines

In the Philippines, less than 2% of the patients in the private sector could afford to pay the list price for crizotinib (Xalkori®). To increase patient reach to 20% and access to full course of treatment, Pfizer analysed cost impacts according to length of treatment and used the information to create an affordability model. This fed into the design of its PAP (INSPIRE), which offers different pricing segments through capping and personalised discounts ranging from approximately 25% to 60% based on patient’s ability to pay/income. The capping programme was included based on the observation that patients on Xalkori® treatment stayed on therapy for a limited time due to affordability barriers and/or treatment costs. Working with the Max Foundation, which partners with clinicians and hospitals, Pfizer also has a programme to provide medicines free of charge for patients with no other possibility of access. 

India

In India, just 2% of the private sector patients can afford palbociclib (marketed as Ibrance®/Palbace®) at the list price for breast cancer treatment. To increase affordability, Pfizer now makes this available through an assistance programme that caps payments to a set number of cycles of product per patient. Medicine is then provided free of charge if the patient remains eligible. Where patients still find it difficult to make monthly payments, the programme enables a reduction in the number of paid monthly cycles or payments over a longer period. Additionally, the programme PayEase provides loans to eligible patients and guarantors to help them cover the cost of the monthly treatments before the product is offered free of charge. Finally, for patients whose income falls below the poverty limit in India, Pfizer provides all products free of charge.

Mexico

In Mexico, also for palbociclib (Ibrance®), Pfizer has addressed affordability challenges in both public and private sectors: It provides the medicine to all patients treated in public institutions at the same price. For patients with private health insurance Pfizer offers tiered discounts based on the remaining coverage of their insurance. For patients who pay for medicine themselves, Pfizer (a) makes the medicine available at public price for patients who attend public hospitals or are referred from hospital patient associations and (b) offers free goods with a purchase of a set number of paid packs to patients based on their socioeconomic status. More free medicines are given to those with greater affordability issues.