Analysis of the Failure of Monoclonal Antibody (mAb) Treatments in Sri Lanka in Terms of Sales and Pragmatic Solutions to Improve.....

Analysis of the Failure of Monoclonal Antibody (mAb) Treatments in Sri Lanka in Terms of Sales and Pragmatic Solutions to Improve the Sales and Adoption of mAb Treatments in Sri Lanka.

The failure of new monoclonal antibody (mAb) treatments in Sri Lanka, in terms of sales, can be attributed to a combination of economic, infrastructural, cultural, and regulatory challenges. This analysis covers the key factors contributing to this failure and offers pragmatic solutions.

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1. Economic Constraints

High Cost of Treatments: Monoclonal antibody therapies are generally expensive due to the complex and resource-intensive processes involved in their development and production. In Sri Lanka, where the per capita income is low, the high price tag of mAbs makes them unaffordable for the majority of the population.

Limited Health Insurance Coverage: Health insurance penetration in Sri Lanka is low, and even those with insurance may find that coverage for expensive treatments like mAbs is inadequate. This results in high out-of-pocket expenses for patients, further limiting access.

2. Healthcare Infrastructure Challenges

Storage and Distribution Issues: Monoclonal antibodies often require cold chain storage (consistent refrigeration) and precise handling, which can be challenging in a country where healthcare infrastructure, particularly in rural areas, may not be adequately developed.

Access to Trained Medical Personnel: The administration of mAbs requires healthcare professionals with specific training. However, there is a shortage of such trained personnel in many parts of Sri Lanka, which hinders the widespread adoption of these treatments.

3. Regulatory and Market Access Barriers

Lengthy Regulatory Approvals: The process of obtaining regulatory approval for new drugs in Sri Lanka can be slow and cumbersome. Delays in approval can limit the timely availability of mAbs in the market.

Market Entry Challenges: Pharmaceutical companies face barriers in entering the Sri Lankan market, such as high tariffs, import restrictions, and complex registration processes. These challenges can deter companies from launching their products in the country.

4. Competition from Established Treatments

Preference for Generic Drugs: The Sri Lankan healthcare system favors the use of generic medications, which are significantly cheaper than mAbs. This creates a competitive disadvantage for mAbs, especially when there are established, less expensive alternatives available.

Established Treatment Protocols: Healthcare providers in Sri Lanka may be more familiar and comfortable with traditional treatments. They may be hesitant to switch to newer, more expensive therapies like mAbs without clear, demonstrable benefits.

5. Lack of Awareness and Education

Limited Knowledge Among Healthcare Providers: Many doctors and healthcare professionals may not be fully aware of the benefits and applications of mAb treatments. This lack of knowledge can lead to reluctance in prescribing these treatments.

Patient Awareness: The general population in Sri Lanka may have limited understanding of what mAbs are, their benefits, and how they differ from traditional treatments. This lack of awareness contributes to low demand.

6. Cultural and Social Factors

Preference for Traditional Medicine: Sri Lanka has a strong tradition of Ayurvedic and alternative medicine. Some patients may prefer these traditional treatments over modern medical interventions like mAbs.

Mistrust of New Treatments: There may be a general mistrust of new and expensive treatments, particularly if they are perceived as “foreign” or if there is a history of failed or controversial drug introductions in the past.

Pragmatic Solutions to Improve the Sales and Adoption of mAb Treatments in Sri Lanka

1. Subsidization and Pricing Strategies

Government Subsidies: The government can introduce subsidies for critical mAb treatments, particularly for life-threatening conditions like cancer. This can be achieved through public-private partnerships or international funding support.

Differential Pricing: Pharmaceutical companies can adopt differential pricing strategies, offering lower prices in low-income markets like Sri Lanka. This approach has been successful in increasing access to essential medicines in other developing countries.

2. Infrastructure Development

Investment in Cold Chain Facilities: To ensure that mAb treatments are stored and transported properly, the government and private sector should invest in cold chain logistics. This includes better refrigeration facilities at hospitals and improved distribution networks.

Training Programs for Healthcare Workers: Establish training programs for doctors, nurses, and pharmacists on the administration and handling of mAbs. These programs can be conducted in collaboration with pharmaceutical companies and international health organizations.

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3. Regulatory Reforms

Streamline Approval Processes: The government should work on expediting the drug approval process for mAbs, possibly by setting up a fast-track approval system for critical treatments. This can be modeled after successful programs in other countries that have reduced approval times.

Facilitating Market Entry: Simplifying the registration process and reducing tariffs on imported mAbs can encourage more pharmaceutical companies to enter the Sri Lankan market. This could also involve negotiating bulk purchasing agreements to lower costs.

4. Education and Awareness Campaigns

Targeted Campaigns for Healthcare Providers: Conduct continuing medical education (CME) programs focusing on the latest developments in mAb treatments. These should highlight the clinical benefits, safety profiles, and cost-effectiveness of mAbs compared to traditional therapies.

Public Awareness Initiatives: Launch public awareness campaigns to educate the population about the benefits of mAb treatments. These campaigns could include testimonials from patients who have benefited from mAbs, and use of mass media, social media, and community outreach.

5. Incorporating Technology and Telemedicine

Telemedicine for Remote Areas: Use telemedicine to provide consultations and follow-ups for patients in remote areas, where access to specialists might be limited. Telemedicine can also be used for remote training of healthcare providers.

Digital Health Records: Implement digital health record systems to track patient outcomes with mAb treatments, which can be used to improve treatment protocols and demonstrate effectiveness to both healthcare providers and patients.

6. Building Trust and Reducing Stigma

Culturally Sensitive Communication: Develop marketing and educational materials that are culturally sensitive and resonate with local values. Working with local leaders and influencers can help to build trust in these new treatments.

Engagement with Traditional Medicine Practitioners: Engage with practitioners of traditional medicine to explore potential complementarities or to provide them with information that could help them understand and possibly support mAb treatments.

7. Long-Term Strategic Partnerships

Public-Private Partnerships: Develop partnerships between the government, local pharmaceutical companies, and international organizations to co-fund the development and distribution of mAbs. This could also include setting up local production facilities to reduce costs.

International Collaboration: Sri Lanka could collaborate with neighboring countries to negotiate better prices for mAbs through collective bargaining, share resources for training, and establish joint research initiatives to adapt mAbs for local use.

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Conclusion

The failure of monoclonal antibody treatments in Sri Lanka in terms of sales is a multifaceted issue that requires a comprehensive approach to address. By implementing the proposed solutions—ranging from economic interventions and infrastructure improvements to educational campaigns and regulatory reforms—Sri Lanka can enhance the accessibility, affordability, and acceptance of these life-saving treatments. A coordinated effort involving the government, healthcare providers, pharmaceutical companies, and the public is essential to overcome the existing barriers and ensure that monoclonal antibody treatments become a viable option for patients in Sri Lanka.

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References

Vasan, R. S., & Reddy, K. S. (2013). "Financing health care for all: challenges and opportunities." Global Heart, 8(2), 107-114.

World Health Organization. (2017). "WHO Technical Report Series, No. 993, 2015. Guidelines on the international packaging and shipping of vaccines."

Milstien, J., Kamara, L., Lydon, P., & Steinglass, R. (2006). "Vaccine supply and procurement: preliminary lessons from collaboration with the vaccines for developing countries initiative." Bulletin of the World Health Organization, 84(5), 392-396.

Norman, G. R., Shannon, S. I., & Marrin, M. L. (2004). "The need for needs assessment in continuing medical education." BMJ, 328(7446), 999-1001.

World Health Organization. (2020). "Global strategy on digital health 2020-2025." World Health Organization.

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Shamal Fernando

Managing Director – Slim Pharmaceuticals Sri Lanka

BSc.(Psych) MBA , Charted Marketer UK , Professional Trainer UK

Member of American Association of Scientists.