Increasing patient access to TB and HIV/AIDS treatments
Johnson & Johnson targets sub-Saharan Africa and Least Developed Countries to bolster access
Johnson & Johnson
Sub-Saharan Africa and Least Developed Countries; Globally
- bedaquiline (Sirturo®)
- darunavir (Prezista®)
Broadening access to tuberculosis and HIV medicines
To apply equitable access strategies for high-burden diseases
Johnson & Johnson is a leading example in equitable access strategies, with an inclusive access strategy for two of its products that treat high-burden diseases, namely tuberculosis (TB) and HIV/AIDS. In fact, Johnson & Johnson goes one step further to supply its products to South Africa under terms similar to the ones it offers in supranational agreements, although South Africa procures those treatments outside of them.
The Global Drug Facility (GDF) for tuberculosis, established in 2001 and administered by the World Health Organization, ensures that national TB control programmes have uninterrupted access to high-quality medicines by providing direct procurement services and securing competitive prices.In collaboration with the GDF, Johnson & Johnson offers its recommended six-month TB treatment course of bedaquiline (Sirturo®) to more than 135 eligible countries for a not-for-profit price of USD 400 per course of treatment, which was reduced to USD 340 in July 2020.
The company recognises the disproportionate burden of disease in resource-limited settings together with its product’s potential to improve outcomes for patients with multidrug-resistant tuberculosis (MDR-TB). Johnson & Johnson also extends similar pricing terms to a country that does not benefit from the GDF’s supranational procurement assistance. In August 2018, South Africa announced it would move to all-oral second-line drug therapy for MDR-TB. Since then, the company has offered the country its six-month INN (Sirturo®) course at a price level in line with the one set forth in the supranational agreement (not-for-profit price).
Less than half of key products are covered by pharma companies’ access strategies in poorer countries
Access strategies with the biggest potential impact on access to medicine are strategies that aim to make products affordable for all patients across the income pyramid. The 2021 Index finds that many of the world’s poor countries still do not benefit significantly from pharma companies' access strategies.
For sub-Saharan African and least developed countries, Johnson & Johnson sets a ‘special effort’ price for its HIV/AIDS product darunavir (Prezista®). To set this price, the company uses an inter-country equitable pricing framework that considers the economic conditions and disease burden of each country, together with its public health need for the product. The company evaluates countries by gross national income per capita at purchasing power parity (GNI PPP) and measures severity of disease burden across countries. It also considers impact of the disease on economies, the proportion of a country’s population paying out of pocket for healthcare or lacking access to health insurance and demographic factors such as income levels.
The ‘special effort’ price enables distributors to make a fair profit while keeping the price sufficiently low to ensure maximum coverage. Chemonics International, a supranational procurement organisation, benefits from this price to procure darunavir. The company extends similar terms to South Africa, a country directly procuring the treatment. Johnson & Johnson has also issued a non-assertion declaration for this product in sub-Saharan Africa and least developed countries, allowing generic medicine manufacturers to enter the market.