LIST OF PANELS

Affordable access to safe, effective and quality medicines, health products, and other technologies is an essential aspect of Universal Health Coverage, and an unrealized goal in many parts of the world. The United Nations’ Millennium, and then, Sustainable Development Goals, emphasized the role of the private and public sectors to contribute to Universal Health Coverage, including the need for industry engagement to improve access to essential medicines. Since that time, there has been an increase in the number and scope of initiatives and activities by pharmaceutical and medical device companies to facilitate access to medicines and health technologies within low- and middle-income country health systems (Rockers et al., 2017), and also higher-income countries (Prémont & Gagnon, 2014). These activities go beyond advertising and sales strategies and include: price reductions; medicines, device, and equipment donation; compassionate access programs; licensing agreements; service sponsorship; infrastructure investment; provider training; patient support programs; awareness campaigns; and regulatory and supply chain strengthening.

However, there are no global frameworks or guidelines to inform governments or health systems interfacing with corporate initiatives despite known risks, including increased health system burden and costs, such as with many drug and device donations (McDonald et al., 2019; World Health Organization, 2017). There is a bigger question around whether and to what extent initiatives serve promotional purposes to further commercial interests, which are associated with negative public health impacts. Analyses of internal industry documents has revealed the extent of corporate influence within every aspect of the pharmaceutical sector (Gagnon & Dong, 2023), including scientific research, the media, civil society, regulatory processes, and clinical practice. However, the confidential and proprietary nature of many of these initiatives poses challenges for research.

Countries continue to grapple with how to ensure affordable, equitable, and sustainable access to medicines. Pharmaceutical development is growing fastest for higher-cost, specialty medicines for chronic conditions in oncology, immunology, and diabetes; people prescribed these medicines often also require pharmacy, clinical, diagnostic, and ongoing monitoring services. In response, pharmaceutical companies have developed a suite of new promotional strategies to facilitate rapid access and uptake by directly providing such services in the form of patient support programs or funding and operating health services such as infusion clinics or diagnostic testing services. The extent to which this occurs globally is not well understood.

The objective of this panel is to bring together diverse disciplinary perspectives and research methodologies to describe, analyze, and theorize the role of corporations in promoting access to health technologies within global health systems.

The main research questions for this panel are:

1)    What is the nature and range of corporate initiatives to promote access to health technologies within global health systems?

2)    What frameworks or perspectives are useful in understanding how these initiatives operate to promote commercial, public health, or other interests?

3)    What are the considerations for governance and what principles, frameworks, or policy tools might be, or are effective?

References

Gagnon, M.-A., & Dong, M. (2023). What did the scientific literature learn from internal company documents in the pharmaceutical industry? A scoping review. Cochrane Evidence Synthesis and Methods, 1(3), e12011.

McDonald, S., et al. (2019). Medical donations are not always free: An assessment of compliance of medicine and medical device donations with World Health Organization guidelines (2009–2017). International Health, 11(5), 379–402.

Prémont, M.-C., & Gagnon, M. A. (2014). Trois types de stratégies des fabricants pour la fidélisation aux médicaments de marque. Healthcare Policy, 10(2), 79–89.

Rockers, P. C., Wirtz, V. J., Umeh, C. A., Swamy, P. M., & Laing, R. O. (2017). Industry-led access-to-medicines initiatives in low- and middle-income countries: Strategies and evidence. Health Affairs, 36(4), 706–713.

World Health Organization. (2017). Responding to Industry Initiatives to Increase Access to Medicines and Other Health Technologies in Countries. Geneva, Switzerland: WHO.

Since the 1960s, the World Health Organization has sought to promote the rational use of medicines and health technologies and developed normative guidance around industry promotion. Promotion now encompasses not only traditional forms of advertising, deployment of sales representatives, and sponsorship of education or research, but increasingly, industry is involved in the funding or operating of health systems as a means to facilitate access to their products, including within low- and middle-income countries (WHO, 2017). Pharmaceutical and medical device company activities to facilitate access to health products include directly providing health systems with health products through donation, reduced prices or discounts; funding or conducting health system capacity building (e.g., training related to procurement, regulation, or continuing health professional education); providing care through patient support programs; or directly financing Ministry of Health activities (Rockers et al., 2017; WHO, 2017). However, in the context of opaque pricing and confidential procurement agreements; preferred provider networks which create exclusive distribution networks; and problematic tax incentives around donation practices, many of these initiatives are often designed to serve commercial interests to the detriment of public health.

This panel intends to bring together people from different disciplines to discuss ongoing research into and methods to study and identify medically-related industry strategies, initiatives, and activities designed to promote access to health products and technologies. We define the medically-related industry as pharmaceutical, medical device, health technology, infant formula, and medical nutrition industries and the web of commercial entities, trade associations, and lobby groups that seeks to further their corporate interests. We seek research and research approaches oriented toward informing the development of policy tools to ensure equitable, sustainable, and affordable access; promote good governance, public accountability, and transparency; and manage risks and monitor and evaluate performance.

We welcome diverse research designs and approaches (e.g., qualitative, ethnographic, quantitative, documentary, policy analysis and evaluation, case studies), documenting or analyzing industry initiatives in low-, middle-, and high-income countries; as well as theoretical analyses of strategies and their impacts.

The panel will be held on-site, but presenters can present via online platforms if required. Depending on the number of submissions and presenter preference, we may elect to organize an on-site and online session.