Non-communicable diseases (NCDs) present a growing challenge for developing countries and create the real possibility that gains in health made possible by better control of infectious disease and economic development are being eroded, warns a new industry report.

The magnitude of these chronic diseases suggests that a robust policy response is needed, and health promotion and disease prevention must be the cornerstones of this response. However, given that NCD medicines offer substantial public health gains, access to medicines is also a critical component of chronic disease care, says the report, which is produced by RAND Health, a division of the RAND Corporation, and sponsored by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).

Top-level findings of the report - which has been published to coincide with the United Nations (UN) High-Level Meeting on NCDs, taking place in New York September 19-20 - show that effective first-line NCD medicines do exist and are now available in generic form. However, in many instances these medicines are still failing to reach many people living in the developing world.

Many potent NCD medicines have already been developed and will continue to be developed, say the authors, adding: "this is contrasted by the experience with some communicable diseases that predominantly affect developing countries, in which case individual pharmaceutical companies find it more difficult to rationalise and recoup the necessary investment in innovative medicines." 

They also find that, with generic alternatives available for most first-line NCD treatment requirements, manufacturer prices play only a minor role in impeding access to such treatments. "Schemes to provide medicines at differential prices to developing countries, which are critical for maintaining access to antiretroviral medicines, are therefore less relevant for many first-line NCD medicines and exist for many NCD medicines that are still under patent protection, such as insulin and inhalers for asthma and chronic obstructive pulmonary disease [COPD]," they say.

The study identifies four priority area for the research-based pharmaceutical industry to consider: - innovative ways to improve NCD medicine adherence; - overcoming barriers to availability in poor and remote areas where large mark-ups, tax and duties along the supply chain, as well as counterfeit products, are an issue; - improving access to primary care; and - removing regulatory restrictions that hamper medicine availability in developing countries.

50% of NCDs are avoidable, so prevention measures such as lifestyle modification are some of the most cost-effective and efficient ways to tackle the magnitude of NCDs across the developing world. However, while prevention is imperative and cost-effective, its impact can only be felt over the longer term, said IFPMA director general Eduardo Pisani.

"We also need to know how best to improve access to treatments that patients in developing countries need more urgently," he added.