The influence of domestic manufacturing capabilities on biologic pricing in emerging economies

Access through your institution Buy or subscribe TO THE EDITOR — Although unsustainable pricing of biologic drugs has generated considerable controversy in recent years, comparatively little

discussion has centered on accessibility and affordability of innovative medicines in emerging nations. In general, the percentage of patients able to access innovative therapies is much

lower in emerging economies than in developed countries; for example, percentage of patients with access to MabThera (rituximab) in Brazil is one-third that in the UK and one-sixth that in

the United States, even though the population of Brazil is more than threefold that of the UK and only slightly smaller than that of the United States1. This discrepancy in access is

particularly pronounced for biologic drugs; for example, only 20% of patients with autoimmune conditions in emerging markets have access to anti-tumor necrosis factor-α biologics. (Access

varies from 29% in China to 12% in Russia and a mere 6% in Brazil.2) What factors lie behind access to biologics in emerging economies, and how are these related to affordability? Here we

survey the prices of biologic drugs across several emerging nations. We show that the presence of domestic manufacturing capabilities translates into high competition and low prices for

biologic drugs for patients in that market; in contrast, emerging countries lacking manufacturing capabilities have no means for diversifying drug provision and insufficient competition to

drive down prices. To address these factors, emerging nations must either build their own manufacturing capabilities or put in place regulatory processes that make it easy for manufacturers

elsewhere (especially from other emerging nations) to enter their market. This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your

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CHANGE HISTORY * _ 01 NOVEMBER 2019 An amendment to this paper has been published and can be accessed via a link at the top of the paper. _ REFERENCES * McKinsey. Biosimilars seven years on:

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H., Hebbi, V. & Rathore, A. S. _Biotechnol. Prog._ 33, 998–1009 (2017). Article  CAS  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Indian Institute

of Technology Delhi, Department of Chemical Engineering, New Delhi, India Anurag S. Rathore & Faheem Shereef Authors * Anurag S. Rathore View author publications You can also search for

this author inPubMed Google Scholar * Faheem Shereef View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Anurag S.

Rathore. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Rathore,

A.S., Shereef, F. The influence of domestic manufacturing capabilities on biologic pricing in emerging economies. _Nat Biotechnol_ 37, 498–501 (2019).

https://doi.org/10.1038/s41587-019-0116-0 Download citation * Published: 03 May 2019 * Issue Date: May 2019 * DOI: https://doi.org/10.1038/s41587-019-0116-0 SHARE THIS ARTICLE Anyone you

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