Second Opinion: Underserved Causes at Home and Away

2023-09-05 |  Shrinivas Anikhindi, Carol Cao & Monique Biryiana

It’s summertime, and while the livin’ may not be easy as the late Lady Ella might claim, we’re all taking some well-needed rest. Our writing team have all had time away in the sun and taken that opportunity to reflect on what often goes forgotten in our daily lives.

Autumn will bring new propositions, new initiatives, and new ways to surface and deliver value to patients and healthcare. Until then, however, we wanted to look outward to those causes we care about most; to remind you they’re there and just as important as they have always been.

First up is an excellent piece on mental health by our very own Carol Cao. A build on last month’s deep dive into the importance of treating mental health on the global stage, this month we explore why it’s so hard for traditional models of pharma to develop solutions for the mental health crisis.

Following that, we turn from home to away, looking at pharma’s investment in building healthcare capabilities globally. We delve into where we have seen great success…but also perhaps where opportunities may have been missed.

So, enjoy these fascinating reads and take some time to think about the roads less travelled in terms of our impact on the globe.

In the meantime, the Second Opinion team will take a break next month and be back in October with a new manifesto. The next year will be all about innovative insights and opinions that will help you bring your strategies to life.


People care about mental health. Mental health is now, as it should be, a vital issue in the eyes of the public. As we covered in last month’s Second Opinion, mental health conditions like depression and anxiety are some of the biggest drivers of disability worldwide, and cases of these disorders are only increasing. Public awareness has been shifting as people now understand mental health to be an essential aspect of overall health, and conversations around mental health are becoming less stigmatised.

With the advent of innovative solutions from biotech companies and increasing ESG obligations, the weight of the pharma industry isn’t being felt in this space as much as it could be. Here, we explore a few ideas to consider how pharma can better meet the needs of their mental health patients.

🏥 Holistic support for long-term conditions.

Physical and mental health conditions are closely related, and their co-occurrence in patients is relatively common. While prevalence depends on the conditions, having a physical condition can increase the risk of developing a mental health condition and vice versa – people with long-term conditions like diabetes, asthma and cancer have a greater risk of developing conditions like depression, anxiety and PTSD. A 2018 study found that up to 20% of cancer patients develop clinical depression and 10% develop anxiety, which was associated with reduced quality of life, lower adherence to treatment, and poorer survival.

It’s crucial that, as an industry, we understand how mental health affects the way people engage with their treatment plans, with the healthcare system, and ultimately how they live their daily lives. Support for mental health must be a fundamental part of the care delivered by pharma. With the advent of patient support programmes, companies have started to see the need for and value of this kind of support.

🔎 People who need help the most often don’t get it.

Often, patients who bear the brunt of mental health issues have the least ability or opportunity to access the healthcare they need. For example, a study across the US and UK in 2022 found that racial and ethnic minorities bore a disproportionate mental health burden during the COVID-19 pandemic. The study noted these groups face significant challenges related to the diagnosis and treatment of mental health disorders, including poor access to mental health services and systematic inequalities. 

Not surprisingly, there is also evidence of the link between inequality and mental health outcomes on a global scale – for example, the incidence of schizophrenia is higher in countries that have worse income inequality. From Teva’s partnership with non-profits to donate mental health medicines across the US and J&J’s pilot partnership in Rwanda to strengthen and expand access to quality mental health care in the country, there is a need for affordable and scalable care models for the treatment of mental illnesses, especially in underserved populations where a lot of patients lack access to care.

🧠 Creative digital ideas for timeworn issues.

Technology is not only helping revolutionise patient care but also enabling companies to consider novel treatment approaches by opening the doors to new ideas. For example, in 2020, a video game called EndeavorRX was approved to be prescribed as medicine for kids with ADHD in the US, a ‘landmark decision’ by the FDA. Key findings in 2021 said that 68% of parents reported improvement in their children’s ADHD-related impairments after two months of treatment. Albeit a small study group, a treatment like this has minimal side effects (the game is built to shut off after a 25-minute session to prevent ‘overdosing’), and there is enough evidence to suggest ideas like this have potential. The uptake of digital mental health solutions depends on the engagement of end users, where behavioural theory heavily comes into play. Innovators in this space should be looking to build a strong evidence base for digital mental health while adhering closely to standardised evaluation frameworks to ensure the value of their solution truly meets the needs of regulators and healthcare providers.

Mental health is no small beast to tackle

We’ve talked about a broad range of ideas here. Still, there are many others pharma can explore, from collaborating with patient advocacy groups and regulatory bodies to ensure a comprehensive understanding of treatment needs, to simply continuing to invest in mental health R&D. KarXT, a schizophrenia treatment from Karuna has been said to be a new hope for schizophrenia patients and an upcoming nasal spray for social anxiety by Vistagen could transform the way anxiety is treated. With some exciting movements on the horizon, we want to see how the pharma industry is making mental health a priority.


Global health initiatives encompass coordinated efforts, often led by international organisations, governments, and non-profit entities, to address pressing health challenges on a worldwide scale. These initiatives aim to improve health outcomes, enhance access to healthcare services, and mitigate disease burdens across underserved countries and regions. Their importance lies in the ability to pool resources, expertise, and innovative solutions to combat disease, promote health equity, and strengthen healthcare systems.

As well as being an influential ally, pharma is an instrumental player in this mission due to its drug innovation, development, manufacturing, and distribution capabilities.

Here we evaluate the three areas where pharma companies have supported efforts to advance global health.

1. Collaborative research and development partnerships

An illustration of partnerships driving research and development for global health improvement is GlaxoSmithKline’s collaboration with Medicines for Malaria Venture (MMV), a not-for-profit research organisation, to develop & distribute the RTS,S malaria vaccine in malaria-endemic areas and fund pioneering research into malaria treatments.

These partnerships allow scientific expertise/resources to be shared, expedite the development of novel treatments, and bring them to market more quickly. Partnering with an organisation with established roots in a particular area may also make treatment distribution easier.

However, developing a novel treatment is only one piece to a complex puzzle – an adequate healthcare system with solid infrastructure is required for efficient treatment delivery and initiation, which may be challenging for countries that do not currently have this in place.

2. Investment in healthcare infrastructure

Takeda’s Access to Medicines program is a comprehensive initiative aiming to improve global access to medicines and invest in healthcare infrastructure, particularly in underserved and low-income regions. Key features of the program include donations of essential medicines, tailored price adjustments, disease management support, and local HCP training.

This type of program enhances patient outcomes when essential medicines are accessible, along with a strengthened & sustainable healthcare system and the upskilling of local HCPs. With these elements working in unison, the program has the potential to reduce disparities in healthcare access and disease burden.

Although, adequate resources and long-term sustainability may become challenging unless financial and logistical resources can be maintained. Healthcare infrastructure must also be culturally and contextually relevant to serve the local population and align with community needs effectively. Establishing effective data collection and monitoring systems is also crucial to assess the impact of healthcare infrastructure investment and make informed decisions for improvements.

3. Capacity building and training

A key component of robust and sustainable healthcare infrastructure is capacity building and training – and the Novartis Institute for Tropical Diseases (NITD) in Singapore aims to build local expertise and capabilities in tropical disease research by offering training opportunities to local researchers & HCPs.

The training programs empower and equip these individuals with the skills and knowledge to contribute to healthcare advancements within their communities – and the NITD initiative has even supported the development of new antimalarial drug candidates to clinical trials. 

Likewise, it’s essential to acknowledge that programs on this scale require a long-term commitment and investment to maintain these opportunities and sustain impact.

Adopting a truly patient-centric and sustainable approach

We know that patient voice is more important now than ever, and we’re seeing an exciting shift in pharma, where they’re adopting patient-centric approaches to their business activities. But are all pharma companies truly considering the voices of all patients (or potential patients) regardless of geographical borders? It’s evident that pharma companies have the potential to create tangible solutions to address the needs of their patient population, as well as contribute to overall healthcare sustainability.

Calls to action

Health inequity is still rife within our world, and pharma has the power to make a difference. Below is a summary of actions they can take to improve global health:

  • Collaborative partnerships: Establish and nurture partnerships with governments, NGOs, research institutions and local communities for shared expertise and resources
  • Affordable access: Ensure affordability and equitable access to essential medicines and treatments, especially in low-income and underserved regions
  • Research and development: Continue to invest in research and prioritise innovations that address critical global health challenges
  • Capacity building: Support training and education programs to empower local HCPs and strengthen healthcare infrastructure
  • Patient-centred approach: Incorporate the patient voice in research, development and decision-making processes to create patient-centred solutions for all patients around the world
  • Sustainability: Develop sustainable models for interventions and collaborations to ensure long-term impact and support

By actively engaging in these calls to action, pharma companies can be pivotal in driving positive change, reducing healthcare disparities, and contributing to a healthier and more equitable world.

If you have any feedback or want to hear more about anything mentioned in this newsletter, please don’t hesitate to get in touch.

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