Day 1: September 12, 2022

Solving unmet healthcare needs is at the top of the agenda for policymakers and international organizations, but there is no global consensus about what constitutes the most urgent priorities, and there are huge variations in access to innovations between countries at all income levels and across the globe.

The session “Addressing Unmet Needs: How do we prioritize unmet healthcare needs and accelerate innovation?” on September  12, 2022 – the first day of the inaugural IQVIA Life Sciences Innovation Forum – discussed the urgency of multi-stakeholder collaborations based on shared, transparent data and evidence; the need to prioritize the fight against antimicrobial resistance; and the opportunity to invest in R&D and increase access to innovations in low- and middle countries, such as the African continent.

With the sharper global focus on improving access and affordability to medicines, payers and policymakers are increasingly questioning if life sciences companies are focused on “areas of greatest unmet need” in pursuing their innovation programs. The gaps between public sector perceptions and life sciences industry priorities are of growing concern – particularly with R&D activity at record high levels and greater focus on innovative areas, such as  cell and gene therapies aimed at  small patient populations suffering from rare diseases – but also carrying high per-patient costs. Questions are also stemming from the lack of clear definitions of what constitutes unmet needs, and absence of global consensus about which areas of unmet health need should be addressed most urgently.

Day 1 of the IQVIA Life Sciences Innovation Forum was intended to close the gap between calls for “prioritizing on areas of greatest need” and understanding the approach taken by the life sciences industry to invest in and pursue biomedical innovation.

The full session may be viewed on-demand here.

The discussion focused on various key issues around unmet healthcare needs:

• Addressing unmet healthcare needs is at the top of the policy agenda for policymakers and international organizations, including the World Health Organization, European Parliament, and the U.S. Centers for Disease Control and Prevention, but the different bodies and organization have distinct priorities, and there is no global organization defining or setting common priorities for addressing unmet healthcare needs.
• There is a lack of validated evidence as to whether available innovation is reaching patients.
• There is no transparency around spending on R&D and innovation across the life sciences industry and in the public sector and for specific disease areas.
• Data and transparency around data can help thread the needle between various stakeholders by engaging multiple parties to partner around the identification and collection of diverse datasets, and co-creating the insights derived from the data.
• Access to innovative therapies, including novel, essential innovative medicines, varies widely, with significant differences in per capital use across countries and continents globally.
• Multiple underlying drivers influence what constitutes the most urgent unmet health needs: the epidemiology of disease, value assessments, costs, payer strategies, patient and caregiver preferences, clinical guidelines, medical practice, and diagnostics.
• Addressing unmet healthcare needs will require multiple approaches: Identifying new pathways for early intervention in “upstream” disease, addressing specific therapeutic needs, balancing disease and innovation priorities across large and small patient populations, advancing access to innovation, and delivering on the promise of “curative” therapies.
• Stakeholders should work closely to address unmet healthcare needs, as no single stakeholder group can solve the challenges on their own.
• We may be arriving at an inflection point over the next 5-10 years where priorities around access to innovation for unmet healthcare needs may shift dramatically.

Select perspectives from the discussion:

• Transparency of industry and public sector funding of healthcare services and investments in innovation: New approaches to healthcare – including use of new therapeutics - should be based on clear, transparent data on value measures relative to existing approaches and reflect investments by both public and private sector stakeholders, including the life sciences industry as well as government bodies that fund research programs and deliver health services.  But such data hardly exists, and where it does, it is rarely shared among stakeholders so that agreement could be reached on areas requiring additional public or private investment.  Absent such transparency, there remains mistrust, uncertainty and lack of progress over where investments should be prioritized and with what expected returns.  Mechanisms for generating and sharing such information are urgently needed.  In the past, for example,  , major cardiovascular medicine studies were conducted to demonstrate outcomes and cost-effectiveness associated with the use of  drugs for hypertension and high cholesterol, to demonstrate reductions in heart attack, stroke and mortality. In oncology, we don’t have similar data on outcomes and cost-effectiveness. Stakeholders must work together to share data transparently.

“Everybody has the right to their own opinion, but not their own data. There is a need for a deeper dialogue between those who create the innovations, i.e., researchers and life sciences companies, and those who use them and pay for them, i.e., patients and taxpayers.” - Bengt Jönsson

• Access to innovations for unmet health needs  in low- and middle-income countries: One of the most significant gaps in access to innovations for unmet health needs is represented by the African continent which, more than any other part of the world, exemplifies the access gap between high-income and low- and middle-income countries. This has been demonstrated over the last 30 years, from the HIV-crisis, to Ebola, to the global COVID-19 pandemic. In the case of HIV, the first anti-retroviral therapies for HIV that transformed the disease from a death-sentence to a manageable, chronic condition were introduced in the developed countries in 1996, but broad access to these life-saving therapies were only made available decades later in Africa when generic versions of these drugs were available. Today, access to new innovations for unmet health needs are generally only available in Africa when mediated via international donor organizations and life sciences companies that have commercial goals and specific strings attached to them. There is a need for the African continent to create its own sustainable funding model for health innovations, which should be sustained by investment not only from governments, but also the life sciences industry and private sources.

“There is a negative perception that Africa is not ready for innovation developed on the continent. But in fact, there is a lot of activity in R&D and innovation in Africa. The life sciences industry should be open to taking some risk and make direct investments in Africa, rather than only go through international funds and donors.” - Olawale (Wale) Ajose

• Antimicrobial resistance is a major global challenge: There is general agreement that antimicrobial resistance (AMR) is a hidden pandemic that has potentially alarming consequences and therefore represents a significant and immediate unaddressed healthcare need. Unfortunately, most large pharmaceutical companies have abandoned the field. Many international organizations and governments have called out AMR as a major priority, but the efforts need to move from declarations to action. The UK government has launched the world’s first subscription-model for antibiotics to pay a fixed fee (a ‘Netflix-type subscription model’) to pharma companies for supplying antibiotics, aimed at incentivizing companies to develop new antibiotics. Other rich countries should follow according to their wealth to replicate this model around the world.

“Successful development of new antibiotics must be rewarded beyond the volume of sales, to attract further R&D investment. Therefore, new incentives are needed that reflect the full societal value of antibiotics. The industry-led AMR Action Fund will buy us time, but we urgently need concrete measures like PASTEUR in the U.S. to be passed to deliver sustainable innovation.” - Thomas Cueni