A novel initiative to improve access to medicines for control of non-communicable diseases in low-and middle- income countries: version 2; peer review: 1 approved, 1 approved with reservations, 1 not approved

The global burden of non-communicable diseases (NCDs) is growing, and access to prevention and treatment strategies remain limited, especially for those in low- and middle-income countries (LMICs). Novel approaches are needed to improve access and affordability of medicines that can treat NCDs in LMICs. The Access and Affordability Initiative (AAI) is a public private partnership aiming to improve access to and availability of essential medicines for the treatment of NCDs and strengthening of health systems. Through this novel initiative a prospective cohort of patients with hypertension and diabetes were followed in Ghana and the Philippines to examine the effect of differential pricing on access to treatment of hypertension and diabetes. An integrated approach including differential pricing, health systems strengthening, improved supply chain management and greater affordability can improve access to medicines for NCDs. While differential pricing has several advantages for improving the affordability of NCD medicines in LMICs, it can’t overcome all barriers as a standalone approach. An integrated approach to health systems strengthening, supply chain management and affordability are needed to overcome key challenges in getting medicines for NCD to patients in LMICs. Availability and affordability of medicines to treat NCDs among vulnerable patients will help achieve Universal Health Coverage (UHC).