BRIC Health Systems and Big Pharma: A Challenge for Health Policy and Management

Document Type : Editorial

Authors

1 Robert F. Wagner Graduate School of Public Service, New York University, New York City, NY, USA

2 Université Paul Valéry Montpellier 3, IRIEC EA 740, Montpellier, France

3 Wagner School of Public Service, NewYork University, New York City, NY, USA

Abstract

BRIC nations – Brazil, Russia, India, and China – represent 40% of the world’s population, including a growing aging population and middle class with an increasing prevalence of chronic disease. Their healthcare systems increasingly rely on prescription drugs, but they differ from most other healthcare systems because healthcare expenditures in BRIC nations have exhibited the highest revenue growth rates for pharmaceutical multinational corporations (MNCs), Big Pharma. The response of BRIC nations to Big Pharma presents contrasting cases of how governments manage the tensions posed by rising public expectations and limited resources to satisfy them. Understanding these tensions represents an emerging area of research and an important challenge for all those who work in the field of health policy and management (HPAM).

Keywords

Main Subjects


"Watch the Video Summary"

  1. Jakovljevic MB, Milovanovic O. Growing burden of non-communicable diseases in the emerging health markets: the case of BRICS. Front Public Health. 2015;3:65. doi:10.3389/fpubh.2015.00065
  2. Jakovljevic MM. Comparison of historical medical spending patterns among the BRICS and G7. J Med Econ. 2016;19(1):70-76. doi:10.3111/13696998.2015.1093493
  3. IMS Health. Pharmerging markets – Picking a pathway to success. http://www.pharmatalents.es/Publicaciones/detalle/7/post&33/like&1. Accessed June 12, 2013.
  4. Hamdouch A, Depret MH. La Nouvelle Economie Industrielle de la Pharmacie. Paris: Elsevier; 2001:54-56.
  5. Tannoury M, Attieh Z. The influence of emerging markets on the pharmaceutical industry. Curr Ther Res Clin Exp. 2017;86:19-22. doi:10.1016/j.curtheres.2017.04.005
  6. Gagnon MA, Lexchin J. The cost of pushing pills: a new estimate of pharmaceutical promotion expenditures in the United States. PLoS Med. 2008;5(1):e1. doi:10.1371/journal.pmed.0050001
  7. Light DW, Lexchin JR. Pharmaceutical research and development: what do we get for all that money? BMJ. 2012;345:e4348. doi:10.1136/bmj.e4348
  8. Fabre G.  Propriété Intellectuelle, Contrefaçon et Innovation. Rouan: University of Rouan and Le Havre Press; 2009.
  9. Naci H, Carter AW, Mossialos E. Why the drug development pipeline is not delivering better medicines. BMJ. 2015;351:h5542. doi:10.1136/bmj.h5542
  10. Jakovljevic M, Potapchik E, Popovich L, Barik D, Getzen TE. Evolving health expenditure landscape of the BRICS nations and projections to 2025. Health Econ. 2017;26(7):844-852. doi:10.1002/hec.3406
  11. Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet. 2017;389(10083):1981-2004. doi:10.1016/s0140-6736(17)30874-7
  12. Global Pharmaceuticals & Healthcare. BRICs' High-Growth Potential Tempered by Country-Specific Risks. https://www.bmiresearch.com/articles/brics-high-growth-potential-tempered-by-country-specific-risks. Published March 21, 2017.
  13. Watt NF, Gomez EJ, McKee M. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS. Health Policy Plan. 2014;29(6):763-773. doi:10.1093/heapol/czt063
  14. Finn M. International Trade Administration. Top Markets Report – Pharmaceuticals. https://www.trade.gov/topmarkets/pharmaceuticals.asp. Published March 21, 2017.
  15. Ezziane Z. Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS): opportunities and challenges. Int J Health Policy Manag. 2014;3(7):365-370. doi:10.15171/ijhpm.2014.118
  16. Jakovljevic M. Recent developments in the world’s leading generic markets. Medicinski časopis. 2014;48(3):140-142. doi:10.5937/mckg48-5071
  17. da Silva RM, Caetano R. "Farmacia Popular do Brasil" Program: characterization and evolution between 2004 and 2012. Cien Saude Colet. 2015;20(10):2943-2956. doi:10.1590/1413-812320152010.17352014
  18. Biehl J, Petryna A, Gertner A, Amon JJ, Picon PD. Judicialisation of the right to health in Brazil. Lancet. 2009;373(9682):2182-2184. doi:10.1016/s0140-6736(09)61172-7
  19. [No Author Listed] Associação da Indústria Farmaceutica de Pesquisa. Guia 2016 Interfarma. https://www.interfarma.org.br/guia/guia_2016/dados_de_mercado. Published 2016.
  20. Passos N. O lobby e a força da indústria farmacêutica no Brasil. Carta Capital. https://www.cartacapital.com.br/blogs/outras-palavras/o-lobby-e-a-industria-farmaceutica-no-brasil. Published August 22, 2016.
  21. Development Trends and Practical Aspects of the Russian Pharmaceutical Industry. Deloitte website. https://www2.deloitte.com/content/dam/Deloitte/ru/Documents/life-sciences-health-care/russian-pharmaceutical-industry-2015.pdf. Published 2015.
  22. Rudisill C, Vandoros S, Antoun JG. Pharmaceutical policy reform in the Russian Federation. J Health Polit Policy Law. 2014;39(3):691-705. doi:10.1215/03616878-2682659
  23. What does Russia import? The Observatory of Economic Complexity. http://atlas.media.mit.edu/en/visualize/tree_map/hs92/import/rus/all/show/2016/.
  24. Shuliak S. Pharmaceutical market 2015: CRISIS. http://www.dsm.ru/docs/presentations/Shulyak_17052016_Adam_Smith_Conference.pdf. Published May 17, 2016.
  25. India Brand Equity Foundation. https://www.ibef.org/exports/pharmaceutical-exports-from-india.aspx. Published May 17, 2016.
  26. Harris G. Medicines made in India set off safety worries.  The New York Times. February 14, 2014. https://www.nytimes.com/2014/02/15/world/asia/medicines-made-in-india-set-off-safety-worries.html?_r=0.
  27. MSF Access Campaign. India upholds compulsory license on cancer drug in Bayer case appeal. https://www.msfaccess.org/content/india-upholds-compulsory-licence-cancer-drug-bayer-case-appeal. Published March 4, 2013.
  28. Ahmad A, Khan MU, Patel I. Drug pricing policies in one of the largest drug manufacturing nations in the world: Are affordability and access a cause for concern? J Res Pharm Pract. 2015;4(1):1-3. doi:10.4103/2279-042x.150043
  29. Shepherd-Smith A. Free drugs for India's poor. Lancet. 2012;380(9845):874. doi:10.1016/S0140-6736(12)61489-5
  30. Nagarajani R. Free drugs plan gets a quiet burial. Times of India website. http://timesofindia.indiatimes.com/.   Published April 5, 2015.
  31. Access to essential medicines in India boosted by drug price caps. https://www.thepharmaletter.com/article/access-to-essential-medicines-in-india-boosted-by-drug-price-caps. Published December 8, 2015.
  32. Roy V, Gupta U, Agarwal AK. Cost of medicines & their affordability in private pharmacies in Delhi (India). Indian J Med Res. 2012;136(5):827-835.
  33. Wang H, Gusmano MK, Cao Q. An evaluation of the policy on community health organizations in China: will the priority of new healthcare reform in China be a success? Health Policy. 2011;99(1):37-43. doi:10.1016/j.healthpol.2010.07.003
  34. Fabre G. The Chinese healthcare challenge; Comment on “Shanghai rising: avoidable mortality as measured by avoidable mortality since 2000.” Int J Health Policy Manag. 2015;4(3):195-197. doi:10.15171/ijhpm.2015.36
  35. Yip W, Hsiao W. Harnessing the privatisation of China's fragmented health-care delivery. Lancet. 2014;384(9945):805-818. doi:10.1016/s0140-6736(14)61120-x
  36. Chitour H. Big Pharma in China—The Driving Forces behind Their Success—A Qualitative Analysis. Chinese Stud. 2013;2(4):169-177. doi:10.4236/chnstd.2013.24028
  37. Bioassociates. Top Pharmaceutical Multinationals in China by Investment. BioMed Tracker; 2012.
  38. Opportunities in China’s Pharmaceutical Market. Chinese Pharmaceutical Value Chain. Deloitte Associates website. https://www2.deloitte.com/content/dam/Deloitte/ch/Documents/life-sciences-health-care/ch_Studie_Pharmaceutical_China_05052014.pdf. Published May 5, 2014.
  39. Hancock T. Big Pharma hopes rule change will ease China sales pain. Financial Times. May 16, 2017.  https://www.ft.com/content/84653126-306e-11e7-9555-23ef563ecf9a?mhq5j=e7
  40. Hu J, Mossialos E. Pharmaceutical pricing and reimbursement in China: when the whole is less than the sum of its parts. Health Policy. 2016;120(5):519-534. doi:10.1016/j.healthpol.2016.03.014
  41. European Chamber. China manufacturing 2025: Putting manufacturing ahead of market forces. http://www.europeanchamber.com.cn. Published 2017.
  42. Big Pharma Gets Boost as Pharma Speeds Up Drug Approvals. Bloomberg News. October 8, 2017. https://www.bloomberg.com/news/articles/2017-10-09/china-launches-overhaul-of-drug-approval-in-win-for-big-pharma
  43. Chinitz D, Rodwin VG. On health policy and management (HPAM): mind the theory-policy-practice gap. Int J Health Policy Manag.  2014;3(7):361-363. doi:10.15171/ijhpm.2014.122
  44. Bigdeli M, Jacobs B, Tomson G, et al. Access to medicines from a health system perspective. Health Policy Plan. 2013;28(7):692-704. doi:10.1093/heapol/czs108
  • Receive Date: 22 October 2017
  • Revise Date: 23 December 2017
  • Accept Date: 23 December 2017
  • First Publish Date: 01 March 2018