The future success of pharmaceutical companies and the wider industry depends on how well they can address the intertwined issues of drug innovation, access and affordability, said Kenneth Frazier, executive vice-president and president, global human health for Merck & Co, at a symposium in Germany last week.

The symposium on access, innovation and affordability of medicines was held to mark the opening of Merck’s new regional headquarters for Europe, Middle East, Africa and Canada (EMEAC) in Munich. As Frazier pointed out, the EMEAC region encompasses 135 different countries and 1.9 billion people, among them some of the world’s most affluent and most disadvantaged populations. Serving their diverse needs would be the “first order of business” for the new HQ, Frazier promised, recalling former president George W. Merck’s maxim that “medicine is for the people”.

In facing these challenges, though, “no single answer will suffice”, he warned. Balancing innovation, access and affordability called for tailored solutions, undertaken in broad partnership, Frazier commented.

His colleague Dr Stefan Oschmann, Merck & Co’s president for Europe, Middle East, Africa and Canada, elaborated on this theme, telling the symposium that healthcare must be a joint endeavour involving all components of society. That included both patients playing a wider role in setting the pharmaceutical research agenda and governments understanding better the processes that brought medicines through development and into the marketplace.

The most important issue for patients was rapid access to therapies, Oschmann said, referring to the current ‘postcode lottery’ for some new drugs and emphasising that healthcare systems must be built for, and remain in service of, patients. The innovative thinking that had driven the longevity gains of the last 15 years should also be applied to the conception, design and financing of healthcare systems, he argued.

Developing world initiatives
One area in which Merck & Co has made good on its partnership principles is through developing world initiatives such as the Mectizan (ivermectin) Donation Program, for the treatment and prevention of onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis) in Africa, the Middle East and Latin America; and the African Comprehensive HIV/AIDS Partnerships (ACHAP) between the government of Botswana, The Merck Company Foundation,/Merck & Co, and the Bill and Melinda Gates Foundation.

Under the latter programme, noted Dr Ernest Darkoh, chairman of healthcare services and management company Broad Reach Healthcare, Botswana had progressed from a non-treatment stance on HIV/AIDS to one in which AIDS mortality had virtually been eliminated and 90% of people who needed to be on antiretroviral therapy were now receiving the drugs.

Mention of these initiatives was timely. The symposium came in the same week as a highly critical report from Oxfam that accused pharmaceutical companies of offering only patchy concessions around high-profile diseases in developing markets while denying millions of people access to life-saying treatments.

Industry has often insisted it cannot be held responsible for failures of management, infrastructure or local funding that limit access to medicines in developing countries. In Munich these arguments were implicitly endorsed by Dr Darkoh, who said many of the health challenges facing the developing world could be addressed by cultivating leadership skills, harnessing local resources and new technology to tackle grave shortages of healthcare workers, and by overhauling “critically flawed” healthcare systems geared to diseases that affected only 1%-2% of the population.

Siting the new Merck headquarters in Munich, at the centre of Germany’s biotechnology hub, also reflects the pharmaceutical industry’s need to tap into innovative R&D at a time when Europe is slipping behind the US in the discovery and development of novel medicines. Emilia Müller, state minister for economic affairs, infrastructure, transport and technology, told the symposium that Bavaria was one of the top three biotechnology locations in Europe, with around 150 young companies having emerged in the sector over the last 10 years.