Written by Chris Shilling
Access to healthcare is recognised by many international organisations and national governments as a human right. Many challenges that stakeholders face in reaching value-based pricing and reimbursement decisions are a result of the fundamental challenge of how to balance limited finances with the right to health.
While medicines are indeed critical to life and health, it is hard to argue that they are more important than food. Yet the right to food is not enshrined in legislation of different nations to nearly the same degree as the right to health. Two members of our Akceso family in the UK are involved in initiatives that seek to address the resulting need.
Applying Medicines Affordability Pricing To Food?
The Sunrise Café has just celebrated its first anniversary of providing meals to anyone in need. In the same way that many health services use ability and willingness to pay models with co-payment schemes, the café was founded with a ‘pay-what-you-can’ model.
It provides a standard menu with daily special options, all with a listed price. Customers can order any meal, but if they can’t afford it then the café – funded through a combination of regular income and charitable donations – will cover the cost of that meal. This ensures that people have the opportunity to receive healthy, nutritious food regardless of their financial circumstances.
The ‘Netflix Model’
Your Local Pantry is a national franchise in the UK that provides infrastructure to help volunteers set up ‘surplus supermarkets’.
Using a Netflix model – in the same way that several governments provided unrestricted access to Sovaldi – members pay a weekly subscription to be able to obtain a basket of products that have a much higher value than the subscription fee.
These products are sourced from food producer and supermarket overage as well as farm ‘gleaning’ (sourcing excess fruit and vegetables from local farms that would otherwise be thrown away). In the same way that pharmaceutical companies try to ensure that products nearing their use-by dates are provided for charitable use rather than wasted, this model reduces waste and increases opportunity.
The Pantry that our Akceso team members are involved with serves over 200 subscribers per week – that’s a lot of avoided waste!
Balancing Government, Society and the Individual
A key theme in access to medicines is the responsibilities of the state and the individual, a balance that is very different in different countries. If we applied the different models that people use to access food to how they access healthcare and medicines, might we find new ways to solve the challenges healthcare stakeholders face in providing fair access to pharmaceutical innovation? Perhaps access to nutrition as part of healthcare could be influenced by how society provides patient access to medicines? The Essential Medicines list has become the backbone of healthcare provision in many disadvantaged countries, yet very few governments have an Essential Foods List.