Current situation of Market Access in Chile
In order to delve into the challenges and facilitators of the Market Access In Chile, it is necessary to know what the concept of Market Access. We must be clear that it is an area that is composed of different disciplines, among which stand out: legislation, economics, scientific knowledge, pricing, strategy, health care routes / environment, negotiation, public relations, innovation, among others. Each of these disciplines contribute and shape what we know as Market Access and its development.
Over the years, this area has begun to play a leading role within the pharmaceutical industry, becoming one of the key pillars for these companies, where their main objective is to ensure that their products - mainly innovative and high-cost - reach to the market under supported financing conditions to ensure that patients access innovative treatment and ideally in the shortest possible time.
However, its main difficulty is that it depends on the social and economic context of the country, so it must be adapted according to the needs and variations that are generated in the country. Therefore, the main challenge of Market Access It begins by having to adapt to the changes in the environment produced by the economic, social and legislative barriers to which we are subjected, to work as we go along and to innovate and develop strategies that are attractive to the context.
If we envision the future or the challenge that the Market Access In Chile, it must be clear that our country is in a historical process, facing central questions about governance, its social contract and the economic model.
From an economic point of view, we have two main milestones that put the economic sector in not so favorable scenarios. On the one hand, since October 18, 2019 in Chile the well-known social outbreak has been unleashed in which citizens exposed the vulnerability of the socioeconomic system, with protesters demanding a change in the political and social direction of the country. The stagnation of growth and productivity in the last decade has raised questions about the sustainability of the country's growth trajectory and about the type of reforms that are needed. This led to a significant decrease in the country's economic development, and which months later was affected by the emergence of the COVID-19 pandemic that has caused the economy to collapse, to the point of seeing the worst recession in decades. GDP contracted by 6.0% in 2020, although a decrease in containment measures allowed a partial recovery towards the end of that year. This situation caused the loss of more than a million jobs, which mainly affected women and workers in commerce, agriculture and hotels, generating an increase in poverty.
This leaves us in a very unfavorable economic scenario, where the State is focusing its expenses on the sanitary containment of the virus and seeking to provide support to contain the poverty of the country, therefore, Health Expenditure - different from COVID-19 - is seen restricted, which undoubtedly leads to maintaining this high out-of-pocket expense that currently exists in our country. This aspect generates unavoidable additional tensions in the financing of the National Health System.
As mentioned above, the development of social movements has led citizens to once again have a voice and to be a key actor in showing their needs and managing to incorporate their demands into legislative conversations, therefore, society is an actor that it will be relevant when the pharmaceutical industry wants to reach agreements and incorporate new technologies.
Therefore, in this new context, the turnaround and prominence that the pharmaceutical industry has to take, specifically the Market Access, will be linked to permanent updating, continuing to innovate to propose new ways of collaborating and engaging all parties in order to serve patients and society by taking care of their health, being proactive, approaching evaluators and decision makers with innovative collaboration proposals, understand their needs and interests and understand all relationships and influences.
Although this was a model that had been developing for some time, now it will be vital to generate commercial agreements, implement shared risks and value proposals that are a support for the Health System given the economic context, and that seek to show results in health , improvement in the quality of life of patients, together with the reduction of costs associated with a pathology, generating an attractive efficiency for the system. Health authorities are faced with the challenge of providing the best health services, but doing so in a way that optimizes health spending.
A facilitator of this entire process for the pharmaceutical industry is also the patient, given the latest social mobilizations, it is made known that the voice of citizens is vital when making decisions or addressing key socioeconomic issues, therefore, the The role that the patient fulfills today is important, since it makes visible existing health problems, such as the high out-of-pocket expense that makes access to some treatments unattainable.
These same mobilizations show the public's dissatisfaction with decision-making behind closed doors and without transparency in the processes by which the selection of a specific technology is determined. Knowing this process clearly would help the pharmaceutical industry to understand the reason why certain technologies are or are not selected, managing to develop value proposals for their technologies that are focused on these needs and managing to incorporate more technologies so that patients can access to these treatments.
The current and short-term challenge of Market Access It will be to generate ties with public and private entities of the health system and to involve patients almost entirely in these processes to be an ally of them; with the aim of ensuring that the technology that patients need, and that requires monetary support, can be provided by the State. This will be complemented with the development of the new constitution in Chile, which seeks for the State to be able to provide basic quality health services for its citizens, for which the pharmaceutical industry must join this triangulation and show support of the health outcomes offered by new health technologies.
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1. World Bank, Chile Overview. April 2021 https://www.bancomundial.org/es/country/chile/overview
2. European Federation of Phar Industries and Associations, The root cause of unavailability and delay to innovative medicines, June 2020
3. The Economist Intelligence Unit, “World Industry Outlook: Healthcare and pharmaceuticals,” October 2020, in Deloitte Insights - 2021 Global health care outlook - Accelerating industry change