Challenges and Opportunities to Access Innovation in Latin America: The Case of Combination Therapies for Multiple Myeloma

Cristina Gutiérrez Delgado, V. Abello, Martha Alvarado, Daniel Lew, D. Londoño, E. McElwee, Mariana Rico Restrepo, N. Schutz, S. Stefani, Â. Maiolino
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Abstract

Purpose: To address the barriers limiting access to combination therapies (CTs) in Latin America (LA), specifically for patients with multiple myeloma (MM), alongside a roadmap to address them. Methods: A panel of LA experts was provided with relevant questions to address in a multi-day conference. Responses were discussed and edited by the panel through numerous drafts and discussions until consensus was achieved. Results: The authors identified challenges in CT access in MM in LA and proposed suggestions to address these, including health technology assessment frameworks that assign value to each constituent, adapted legal structures enabling collaborative pricing negotiations, and innovative pricing and contracting mechanisms. These challenges and suggestions apply to CT for other oncologic diseases. Conclusion: Increasing CT access demands concerted efforts from all stakeholders. As regulatory and pricing barriers persist, a great need exists to increase CT access in LA. These suggestions can serve as a roadmap for CT adoption in other countries. Keywords: Latin America; combination therapy; multiple myeloma; value attribution, HTA, access, pricing; reimbursement.
拉丁美洲获得创新的挑战和机遇:多发性骨髓瘤联合治疗的案例
目的:解决拉丁美洲(LA),特别是多发性骨髓瘤(MM)患者获得联合治疗(ct)的障碍,以及解决这些障碍的路线图。方法:向洛杉矶专家小组提供了相关问题,并在为期数天的会议上进行了讨论。小组通过多次草案和讨论对答复进行了讨论和编辑,直到达成共识。结果:作者确定了洛杉矶MM在CT获取方面面临的挑战,并提出了解决这些问题的建议,包括为每个组成部分分配价值的卫生技术评估框架,使协作定价谈判能够适应的法律结构,以及创新的定价和合同机制。这些挑战和建议也适用于其他肿瘤疾病的CT检查。结论:增加CT访问需要所有利益相关者的共同努力。由于监管和价格障碍持续存在,洛杉矶迫切需要增加CT的使用。这些建议可以作为其他国家采用CT的路线图。关键词:拉丁美洲;联合治疗;多发性骨髓瘤;价值归属、HTA、准入、定价;报销。
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