The newest installments in the Map of Biomedicine blog posts take us down the routes that get drugs to patients, primarily in the United States. Of course, we are all patients at one time or other regardless of where we live. Without a doubt, the route to getting effective therapies from the lab to your local pharmacist is convoluted and expensive even if you live in a wealthy nation. If you don't, making the most effective treatments available to the people who need them most in middle- and low-income nations is more difficult.A major factor in getting drugs to patients is cost -- and that's true no matter where you live. However, if you live in a developing nation, it is unlikely that your national health plan will foot the bill for very effective, but prohibitively expensive drugs like Gilead Sciences' and AbbVie's Hepatitis C drugs, which cure 90% of the people who get treated with them. That is phenomenal, but then again, so is the price. Payers spend between $63,000 and $94,000 on the drugs, according to the Pharmlot blog on the Wall Street Journal's website. What's a middle- or low-income healthcare system to do?
Enter the World Health Organization.
Since 1977, WHO has issued an Essential Medicines List every two years. A panel of experts from pharma, medicine, research, public health policy, and other areas of the healthcare world assemble a list of the pharmaceutical compounds that are the most effective against what the organization calls "priority diseases" and "priority conditions." The goal of the list -- the 19th edition of which has just been published -- is to ensure that public health systems have access to the minimum number of the most effective medications required to keep their populations healthy and to increase the probablity that even in very cash-strapped healthcare systems, getting the very best treatments for serious diseases that require specialized care isn't out of the realm of possibility.
Being on the list is (of course) good for patients, in that it reduces the cost of care and increases patients' access to the most effective treatments in the world. It's also not a bad deal for drug makers because even though they make their therapies available at lower prices, they reach a larger number of people and healthcare systems. Plus there is a certain cache to having developed a medicine that is practically indispensible to populations' health.
This year, AbbVie's Viekira Pak and Gilead Sciences' Sovaldi and Harvoni were among 5 other treatments for hepatitis C and 16 cancer medicines added to WHO's Essential Medicines List that might otherwise be out of reach for many. The list isn't perfect; there are lots of very effective medicines that will continue to be out of reach for lots of healthcare systems. But it is a start.