Access to quality medical products is a complex health and development challenge. It depends on the physical availability and financial affordability of a product as well as its geographical accessibility and sociocultural acceptability.
At the same time, access is subject to both supply (i.e. products and health systems’ services) and demand (i.e. people’s needs and resources).
Whether a patient will gain access to a product can be assessed along the pathway of a product. We have identified six key steps on this pathway – from research and development to ultimately the use of the product by the patient. These key steps are interlinked but do not necessarily have a chronological order (see graphic).
Access barriers to quality medical products can be different depending on disease and product. We need to adapt approaches accordingly.
The pathway of quality medical products
1) Research and Development (R&D)
Physical availability of a new quality medical product depends first on R&D. Different incentive mechanisms, including intellectual property rights, market size and expected revenues, are needed to stimulate R&D. Only when quality medical products successfully pass through research, early development and clinical development, is there a chance that they will ultimately reach and benefit patients.
2) Regulatory Systems
If successful at clinical trial stage, a product is then evaluated by national or regional regulatory authorities to ensure that it meets standards for efficacy, safety and quality – it is approved if the benefits outweigh the risks.
In many countries, before introduction into the national list of essential medicines or into reimbursement schemes, products undergo cost-benefit analyses. If the products are evaluated as cost effective, they may be reimbursed by financing schemes which may positively affect the product’s affordability. But affordability also depends on the purchasing power of patients and their families, and on the supply side on the price set by manufacturers.
4) Supply and Distribution
Further along the access pathway, geographical accessibility of products is influenced by available local infrastructure and logistics. Inefficiencies in existing supply chains and distribution channels can compromise geographical accessibility of a medical product.
5) Healthcare Facilities, Equipment and Personnel
Access to medical products also depends on factors such as availability of health facilities, qualified healthcare providers and medical equipment.
6) Patients’ Health-Seeking Behaviour and Adherence
Medical products must be acceptable to patients and providers. This can depend on factors such as cultural norms and beliefs, whether it is a generic or branded product, or on product features, including form, dosage, taste and colour.
Last modification 13.11.2018