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Novel Fixed-Dose Combinations for COPD in Brazil and Mexico Will Compete With Well-Established Therapies in an Environment Dominated by Aggressive Cost-Control Mechanisms
Date:8/21/2014

e national drug formulary lists a comprehensive range of COPD drugs that can be covered by government-sponsored or Social Security programs, individual institutions have been excluding some key agents based on their own budgets.
  • Private patients' access to treatment: The budgetary environment seems less restrictive in the private sector than in the public sector, but the lack of coverage in the outpatient setting in Brazil and of mandatory coverage in Mexico—together with expensive out-of-pocket costs in both countries—is limiting some eligible COPD private patients' access to treatment.
  • Comments from Decision Resources Group Director Andreia Ribeiro, Ph.D.:

    • "Upon the launch of generic LABA/ICS FDCs (GlaxoSmithKline's Seretide and AstraZeneca's Symbicort) and LAMAs (Boehringer Ingelheim's Spiriva), their use is likely to be promoted, due to the tendering purchase models used in the public sector in both countries. COPD patients in Brazil and Mexico are already requesting currently available low-priced generics, according to our survey findings." 
    • "Particularly in Brazil, state coverage and judicial actions are a powerful driver of access to costly agents, especially those not included in the formularies. Also, in some cases, patient assistance programs are the only way for patients to access drugs not covered under a specific public sector scheme, as in the case of Seguro Popular in Mexico. Manufacturers should explore these opportunities to best position their drugs in these markets."

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