Transcript Slide 1
Access to Treatment: Asia
Abd Razak Muhammad
Malaysia
CML Horizons, May 2012
The Region: Asia Pacific
Just over 4.2 billion people
live in the Asia-Pacific
region in 2010,
constituting 61% of the
world’s population.
Source: United Nations Population Division.
World Population Prospects: The 2010
Revision.
Difference in
Culture
Food
Languages
Healthcare systems
Challenges in Access to Treatments
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No reimbursement
Health authority says “too expensive” –
economic point
Patient burden in co-pay in long term treatment
Capped in budget for drug – waiting list
? Corruption ? Inefficient in being referred for
reimbursement
Drug is not approved
Logistic challenge
Generic version
Paths to Access to Treatment
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Government funded - full, partial
Insurance coverage - with limitation
Employer support - full, partial
Industry program
Self funded
Clinical trial
Named patient donation - compassionate
No access ?
Imatinib Access - Case Example: Malaysia
GIPAP, 2002
Patient - Industry
MYPAP, 2007
NOA, 2012
All hospitals
Government – Industry
Financial status
MOH & MOE hospitals
Patient – Industry
Fixed access scheme
Private hospitals
Fixed access scheme
Employer coverage
Insurance coverage
Full self funded
Clinical trial
A Malaysian patient will
have access to Imatinib.
Malaysia: Successful Model
MOH
Excellence in
Patient Care,
including
treatment
access
Network of CML Advocate Groups
In Asia Pacific
Our dream comes true – Rising Sun
2012, 3rd RS
Malaysia
2010, 1st RS
Hong Kong
Novartis organized
35 delegates
2011, 2nd RS
Community-driven
Singapore
Multi-sponsors
Novartis organized
(Novartis, Ariad, Pfizer,
Stem Molecular
Diagnostics, printing
companies)
42 delegates
54 delegates
Known CML Patient Groups in AP
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India – Friends of Max
Indonesia – ELGEKA
Malaysia – Max Family
Thailand – Thai CML Patient Group & MaxSmiles
Philippines – Touched by Max
Vietnam – Max’s Vie
Pakistan – KIRAN
Japan - IZUMI
China – New Sunshine
Rising Sun 2012
– Meeting at A Glance
30 March 2012 – 1 April 2012, Kuala Lumpur
> 50 delegates
• 2 sessions - CML related, with survey among
participated countries
• 1 session - Clinical trial
• 3 Capacity building & Advocacy
• 1 Country Best Practices Show & Tell
• Posters display
6 SCs : Anna Williamson, Zhengchen Liu, Rod Padua,
Dr Razak, Viji Venkatesh, Mei Ching Ong
SC: Try to know more about what we do not know
Survey
The Existing Standards of Treatment, Monitoring
and Other Support Systems
For CML Patients in the Asia Pacific Region
Aims:
Collect background information on
• current status of CML care and support system
available to patients
• challenges, experiences could be shared and
learned and some issues could possibly be
improved
Based on the best knowledge of participants
May not reflect accurate information
No statistical significance could be inferred
Findings only for basis of discussion
Countries participate – 13
• Australia
• China
• India
• Indonesia
• Japan
• Malaysia
• Pakistan
• Philippines
• Singapore
• Sri Lanka
• Taiwan
• Thailand
• Vietnam
SECTION A:
TREATMENT AVAILABILITY AND
ACCESSIBILITY
Results
Hydroxyurea, Interferon and TKI (at least
one) are available in ALL countries
Stem cell transplant is NOT AVAILABLE in
Indonesia and Sri Lanka
Only Japan & Australia have all TKIs as
first line
How is CML oral therapy (TKI) made
available in your country?
7
fully funded program
3
partially-funded program
self-funded
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Majority access through partially-funded program
Some patients in Thailand, Malaysia and Singapore
self-funded their TKIs
Which fully-funded drug access
program exists in your country?
GIPAP/NOA
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2
2
government
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non government
corporate + government
full insurance
• Most countries has GIPAP/NOA
• Sri Lanka and Vietnam has full funded government program
• Malaysia has corporate-government shared program
• Singapore has non government full funded program
• Singapore and Taiwan have full insurance reimbursement
Which partially-funded program exists
in your country?
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3
corporate
government
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non government
insurance
Almost all countries has a program that patient need to share
with either corporate, government, non government or insurance
company
Is 2nd generation TKI (other than Imatinib)
available in your country?
2nd generation TKI is available in all
countries EXCEPT Sri Lanka
How do CML patients have access to
2nd generation TKI?
drug assisted access
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1* 1#
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program
government sponsored
non government
sponsored
corporate sponsored
clinical trial
• Majority access through clinical trial
• government sponsored in Japan, Thailand, Vietnam and
Australia
• *corporate sponsored in China
• # non government sponsored in Singapore
end of Sec A
Key Learning from Survey
• TKIs are available in most of the countries , however access
remains a big challenge
o financially (partial reimbursement)
o logistic difficulties (China, Indonesia, India)
• Thai CML Group managed to lobby government to include “social
security” patients in imatinib reimbursement
letter writing
group of patients made appointment with authority, work
with media
• Support from key physicians in getting government funding for
treatment access is equally as important as lobbying from patient
groups.
Thank You