Sustainable Distribution for Essential Medicines

Sustainable Distribution for Essential Medicines in Emerging Markets Business Case Background The Sustainable challenge Current distribution climate of Cure Pharmaceutical The growing importance of the emerging markets Barriers to growth Procurement and Distribution Challenge to overall sustainability in pharmaceutical companies Partnerships utilized in emerging markets and essential medicine distribution Suggestions of partnerships effective in essential medicine distribution Data gathering in essential medicine distribution Sustainable distribution for essential medicines in emerging markets Business Case Background This report addresses the role pharmaceuticals play in emerging markets.

Many people have associated these markets as havens for explosive future growth, but there are also serious challenges to be faced. The report will discuss what views investors, stakeholders, and company executives hold on emerging markets. There are three probable significant factors that may sway their stance. First, the reforms recently made by the government regarding pharmaceuticals and the obligations of multinationals resulting from the reforms. Second, the direction that shall be taken by the expanding healthcare market and the adaptation of the industry to it.

Third, what response these changes trigger from the industry. The market in the emerging markets already exists and it is undergoing rapid expansion. Adjustments in products may be needed but the market is deserving of real attention. The value proposition should not be paid much attention to right now but focus shifted to volume proposition. Opportunities exist to better access as well as affordability in an equitable and sustainable manner (Faunce, 2005).

The pharmaceutical industry has always esteemed the emerging markets as the "promised land." By 2016, the emerging markets will account for around one third of the pharmaceutical market globally. These markets are highly populated, have increasing consuming power and longevity, and so they have become quite attractive to companies that have stagnated due to mature markets, regulations, and expiry of patents. While huge potential exists in these markets, there are huge variations in their development stages particularly as concerns healthcare infrastructure.

Because of this, there isn't one plan that can adequately cater for all of them. Even within the market segments, there are variations that require that approaches be customized. Because of the diversity, it is absolutely necessary that the companies establish those markets in which they wish to establish a presence right now and those which can be tackled later. Also of concern is the determination of the best business strategies that can fit a given market and the right time lines.

The organizations which failed to do this in the past have made losses in both confidence and revenue. These lessons must be taken to heart because they give the guidelines for the building of sustainable businesses in the future. 27% of executives have indicated that strategies that aren't hugely tailored are the biggest mistake; while a quarter of them criticize impatience and failing to strategize.

The World Health Organization (WHO) says that the objective of the Universal Health Coverage (UHC) is ensuring that everyone is able to get health services that they require without going through economic hardship in paying for the services (WHO, 2012).

The UN and WHO have stressed that medicine access is a key pillar of UHC; the requirement is that medicines be available continuously at affordable rates at both private and health facilities, or other outlets selling medicine that are no more than an hour's walk from the populations' homes (UN Development Group, 2003). Globally, a resolution on affordable universal healthcare was adopted by the UN General Assembly (United Nations General Assembly, 2012).

The goal lays emphasis on the UHC on the post-MDG agenda and is probably going to be a great influencer of policy and health donations. Cure is one of the most notable oral thin film (OTF) manufacturers around today. It offers the leading development and manufacturing of OTC products, veterinary medicants, pharmaceuticals, and neutraceutals. Besides its OTF technology, the company has put forth innovative products in platforms like transdermal and sublingual applications.

Overall, Cure has more than ninety years of experience in the world of pharmaceuticals in both formulation and manufacturing. It has earned the respect and trust of millions of customers the world over (KAMAE, 2010). Cure creates solutions that provide both social and health benefits to people. The team at Cure is grounded on the creation of a better means of delivering drugs to both humans and animals.

The mission of the company has seen Cure go to the developing world which is need of fresh drug delivery systems and also expand their operations at home where companies are looking for innovative means of delivering drugs that can ensure efficiency and speed. The company is just taking off and the team is working hard coming up with fresh formulations, processes as well as delivery systems that ensure that the key drug actives are sustained and life extended to ensure their efficacy.

Introduction Cure Pharmaceutical (Cure) falls under the sector of drug delivery technology. One technology that was designed by Cure helps patients take their medications effectively without having to use water. The Oral Thin Film technology (0TG) is patented and is small in size, light in weight, and occupies less space in packaging. This technology ensures that drug transport is easy and the dosage convenient. The belief is that fostering a sustainable community takes everyone and that medicines should be successfully distributed to markets like the Sub-Sahara Africa.

The Sustainability Challenge Sustainability Challenge The challenge involves coming up with a distribution model that is sustainable through the development of partnerships that shall help the company to access the developing nations faster and in an effective manner. The business model is the distribution of essential medication like the OTF pediatric malaria treatment to sub-Sahara Africa. Some of the barriers are regulations in the countries, education gaps, social unrest, and broken supply chains. A couple of dynamics determine portfolio success in Africa.

First, the extent to which a corporation can offer services and products where there is enough demand, and optimize their offering for price/volume trade-offs between private- and public-paying markets. Second, the company's ability to bank on brand awareness and loyalty. The challenge and the current situation In Africa, there are several counterfeit products so safety is often a primary concern. The consumers are actively looking for genuine products so the notion that company's can get away with selling second-rate products is ill informed and unsustainable.

Companies have to figure out the optimal volume/price trade-offs. Identifying the right product portfolios for particular nations will require the companies to first comprehend the way the portfolio is aligned with customer segments in the market and them make priorities accordingly based on the information gleaned (KAPLAN et al. 2012).

Wider relevance Generally, countries in the developing world do not have enough resources for the training and support of officials so that they have the needed pharmaco-economic know how to allow for efficacy, interlinked safety as well as effective "Cost-Effectiveness Analysis of Pharmaceuticals" or "CEAP" and "Cost-Effectiveness Analysis of Medical Devices" or "CEAMD" evaluations.

In response to the community and the employees of the companies' concerns on social justice that arise from high rents on intellectual property, the industry has suggested self-regulatory options that emphasize on public-private partnerships, covert differential pricing and pharmaco-philanthropy. Several developing countries are dependent on the WHO's Essential Medicines List. Commentary on relavance The recent interest drawn upon global problems with pharmaceutical cost effectiveness and safety has resulted in medical devices being considered in regulatory discussions. Pharmaeconomics and Outcomes Research (ISPOR) is trying to deal with the imbalance.

Devices really create special difficulties, specifically in areas of skill development and getting blinded trial data, product modification frequency and inefficient regulatory theory. Current distribution climate of Cure Pharmaceutical Policy framework The setting of policies is an ongoing process that keeps up with fresh developments in the national and global landscape. The formulation of policies by countries is often based on proposals of a team of experts that meet on the request of the health ministry.

Other influencers that might have a say on policy formulation include the Global Alliance for Vaccines and Immunization (GAVI) which makes significant contributions in the areas of national immunization programs. A sound comparison of the average prices of drugs should have generics as well as products that can be found over the counter which can substitute prescription drugs from big brands. In achieving this representation, nonetheless, same manufacturer, dosage form, pack size, strength and same brand requirements must be done away with.

With an approach of that nature, it is more plausible to get a good comparison of drugs. Actually, it has been noted that price comparisons of international drugs are relatively weightier as compared to other metrics like methodological issues and consumption patterns. Currency conversion rates and purchasing power rates should therefore be considered, The growing importance of the emerging markets Stakeholder and community interest The challenges presented above will be accentuated with the vitality that the emerging markets are gaining.

While the prosperity of citizens of these nations is increasing, they often take care of at least half of the drug cost themselves and very few of them have the purchasing power of customers in the developing world. Furthermore, choices made here are influenced by product or service design tailored for consumption in these economies. Purchasing power and the cost of the products are weightier than that of convenience, for instance. A number of challenges are also presented by the Green agenda.

All the companies in this industry are already striving to meet tough environmental regulations. However, it looks like the regulations are bound to become even stricter as the international community seeks to reduce carbon emissions, populations rise, rapid climate change and urbanization take shape, and as fresh waters are encroached upon. Many pharmaceutical companies' design is such that a lot of water and energy is required, although some efforts are being made to shift to lower-water chemical syntheses.

Reducing the consumption of these two is going to be costly and this is likely to be passed on to the cost of the products. This makes adapting prices for the emerging markets quite a challenge. Governments can however introduce incentives -- mainly tax incentives -- for companies that decide to go green so as to reduce their carbon blueprint. This is a more sustainable option than having companies shift their manufacturing facilities to territories that are more accommodating of their less attractive manufacturing processes.

Challenge to overall sustainability in pharmaceutical companies Despite numerous biomedical research advances and healthcare technologies, the burden in healthcare is globally increasing. Huge challenges in pharmaceutical companies exist and these challenges in a few decades are set to enhance the ages of global population. For sustainable future health, new strategies and therapies, there will have to be changes in the operating models in the contemporary market.

There have to be changes in the current operating models in the pharmaceutical industry and regulatory agencies, along with the academics as well as the public and private funders (HUNTER, 2011). Data gathering in essential medicine distribution Facility surveys are crucial in data gathering since they focus on a range of key health services and get data on infrastructure of the facility, supplies, equipment and support system as well as standard adherence. Data collection on the availability of essential drugs, and other commodities, is imperative in the survey.

HAI and WHO have come up with a methodology that is standardized for facility, based on prices of medicine, of approximate affordability and other components. Such a survey shows data on the price and availability of medicine, through numerous visits to public sector and medicine outlets too. More so, it can include other sectors and dispensing points like mission hospitals and NGOs. Key informant surveys are also crucial in data gathering.

They are carried out by experts that have extensive knowledge concerning the medical situation in a given country (World Health Organization, 2005). Organizational Progress Having access to medicine as per WHO's universal health coverage umbrella is UHC's goal. The goal is to ensure that every person can obtain health services that they require without going through financial strains in securing the services (WHO, 2012). The UN and the WHO have stressed that medicine access is a key UHC component.

Globally, the General Assembly did adopt a resolution in 2012 on universal healthcare that is affordable and it was supported by countries drawn from varied economic positions (Gorokhovich, Chalkidou, and Shankar, 2013). The international market for innovative medical devices and pharmaceuticals has grown to be a key sector for government spending in healthcare, especially as corporations leverage high rents from heightened standards of intellectual property. The influence on public policy is bound to exponentially grow as the involved products are re-shaped innovatively by gene and nanotechnology and given the right prices.

The elderly, regulatory and control environment, reducing government control are some of the factors that are likely to play a role (Faunce, n.d). The emerging economies are characterized by higher GDP growths when compared to Europe and the U.S.A. In spite of the toned down IMF forecasts on the growth of these economies to be around 5.3% to 5.6%, this is far higher than that of 1.3% and 1.5% to be had by the established economies.

A lot of debate is on the nature and pace of the growth with some dismissing the growth arguing that it is just as high because they are coming from low bases but it is apparent that it is bound to have far reaching implications if the lessons from China are to go by. These markets are also characterized by high demographic growth and 97% percent of the global demographic growth is expected to be accounted for by Africa, Latin America and Asia.

Evidence of Theory Urbanization is also taking shape in these economies and is expected to peak in the coming years. Most of the people moving to urban areas are setting camp in informal settlements. With such settlements, there should be preparation in the health industry because of the implications on health presented by overcrowded informal settlements. Urban centers give their residents an opportunity to better their health but some risks cannot be foregone. With overpopulation of the informal settlements, we are likely to see communicable diseases spread.

And then there are injuries, road accidents, violence, mental health issues and unhealthy lifestyles that are common place in urban centers. The rising populations are also likely to stretch both the natural and artificial resources available in the cities. Due to the laws of supply and demand, the prices are bound to increase and this will result in many families spending more of their income on basic needs like food and shelter.

With less disposable income left to spend on medication, the health industry will have to think of a way to price their drugs for such a population or they won't be able to afford them (BORS et al.,. 2015). Partnerships utilized in emerging markets and essential medicine distribution The private sector and commercial sector play an increasingly pivotal role in essential medicine distribution. Market consolidation does vary greatly in many countries, like Mali, having two wholesalers controlling 80% of the market share.

In the developing world, most wholesalers reach the private sector at a given scale with obstacles to countrywide distribution that includes infrastructure that is underdeveloped and delivery to areas that are geographically difficult to get to. Population density is a shorthand measurement for estimating costs of logistics. In partnership, planning on the amount of medicine to distribute to a given population and measuring the required logistics is crucial (MATTHEWS, 2014). It is crucial that all the partners working in the supply of essential medicine are known, especially within a country.

This will help identify partners to work with in the distribution. Barriers to growth Market access is one of the several challenges faced by pharmaceuticals in the emerging markets. It is a common problem that is getting attention from policy makers in the health industry. The barriers can be categorized into: • Infrastructure -- these nations don't have extensive and reliable infrastructure to ensure that the entire population has access to healthcare.

• Cost containers - several countries are putting in place what can be called "containment measures" so that they can manage healthcare costs. One common measure is not giving to the patients reimbursements. Some governments are relying on tendering for hospital business. Since most of the purchases are out-of-pocket purchases and they account for roughly 60% of the spending, the aim is ensuring that drugs are affordable by for example placing price caps on drugs.

Suggestions of partnerships effective in essential medicine distribution Pharmaceutical companies have to see the value that comes with partnerships that are validating and platforms that are ensuring acceleration to market services and products. While all companies recognize the difference that partnerships have, they can lack frameworks that are useful for refining them. Partnerships need to have a more holistic view that can contribute to overall company innovation. This can include collaborators for access to talents and innovation to new customer insights in the emerging markets (HUNTER, 2011).

Recommendations - what needs to be done Procurement and Distribution Procurement and distribution is all about getting the product to the ultimate consumer from the manufacturers. Most of the drug distribution in the country is indirect. It goes through the hands of wholesalers and distributors as well as importers. Companies handling these are seeking to consolidate delivery, purchasing and ordering of the products and become intermediaries between the organizations at the front line and the manufacturers.

Group purchasing organizations tend to negotiate the buying contracts so that they save costs for hospitals and regional health authorities. Distributors and purchases deal directly with the pharmacies by purchasing and selling or distributing the products via different ordering channels. Importers import their drugs from sites in foreign territories and then distribute them in the country. In certain conditions, the government does procure certain medication for the case of being prepared for emergencies (Multi-Stakeholder Toolkit, n.d).

Exploiting emerging markets Emerging markets account for about one fifth of the pharmamarket sales globally and they are a candidate for the driving of future expansion and growth. Realizing this potential will take companies anticipating the reforms governments re to make in the health industry and make adjustments accordingly. Second, the companies should comprehensively understand the direction private healthcare.