ROME – “Relaunching the birth rate, managing chronicity and sustainability are the three major public health challenges that our National Health Service must face in order to continue to ensure universal access to services and care, entering a new normal of coexistence with Covid. But the common denominator of these challenges is one: women’s health. While it is true that 80% of women make decisions about the health of their loved ones and that, according to WHO data, every dollar spent on women’s health generates $20 in economic benefits, looking after the good -being women means having the whole of civil society at its heart, positively affecting the social and economic fabric of a country”.
The ESG (Environment, Social, Governance) strategy is based on these considerations “His Promise” Organon, a pharmaceutical company dedicated to women’s health, which today, on the occasion of the first anniversary of its presence on the world market, has taken up the issue of women’s health with institutions, scientific societies and patient associations at an event in Rome.
“‘His promise’ – they explained at the meeting – is one broad vision strategy aimed at supporting women and girls around the world in their aspirations to well-being. The cornerstones of the sustainability strategy are a plus wide access to contraceptionto avoid 120 million unwanted pregnancies worldwide by 2030, to fight against inequalities and gender parity also within the company, where nearly 50% of employees and 65% of the management team are of women, with the objective of “zero emissions” in the principles of the circular economy”.
According Alper Alptekinpresident and CEO of Organon Italia, women’s health is a “powerful indicator of a country’s prosperity and an engine of social well-being and economic growth – he said – and we we are proud to have chosen it as a priority therapeutic area, in a broad vision that considers it the epicenter of the health of the whole community”.
On the women’s health front, the theme of birth-rate and of fertility, meanwhile, it is among those with the greatest socio-economic repercussions. The trend of continued demographic decline could lead to a significant drop of 32% in GDP in 2070. The Covid emergency, which has led around two out of three couples to postpone the pregnancy project or even to give it up (Observatoire de la Jeunesse), compounded the problem, triggered by long-term factors: the absence of a good family planningthe little information on contraception and difficulties related to timely access to fertility pathways and of assisted reproduction (PMA).
“Data from a recent analysis called ‘NERAD’ – again highlighted by the conference – say that in our country one in four pregnancies is unplanned and 50% of these result in a voluntary termination of pregnancy, with the consequent significant effects on the psychophysical health of the woman”. Weigh, above all, the lack of information about possible contraceptive choices and the almost total absence of educational programs on the subject that limit access to contraception and its conscious use, while the use of emergency contraception is increasing, which already in 2018 led 548,684 women to use it. Italy, as revealed by the latest European Atlas of Contraception developed by the European Parliamentary Forum for Sexual and Reproductive Rights (EPF), ranks 22nd in Europe for access and information on contraception.
WOMEN AND CONTRACEPTIVE INFORMATION: THE STUDY
According to research’The state of the art and the training and information needs of Italian women in the field of contraception‘, conducted by DoxaPharma on a sample of 1,000 Italian women between the ages of 18 and 40 and presented at the event, one in three Italian women of childbearing age have never asked their gynecologist for information on contraception, while 48% were informed via the Internet. The consequence is that women mainly rely on the options they know (hormonal pills and condoms), while knowledge of non-daily contraceptive methods is still limited that can help women adhere to treatment, such as long-acting reversible contraceptives (LARCs): nearly half of women have little or no knowledge ofvaginal ring monthly and on the patch and only 25% know about the long-term implant in the arm.
ACCESS TO MAP
The scarcity of fertility-enhancing techniques is the other side of the obstacle course towards adequate family planning, which penalizes women in their life choices: 1/3 of ART treatments are performed in couples where the female partner is over 40 years old, significantly reducing the treatment success rate, which fell from 21.6% for those under 35 to 4.1% for those over 43. Regarding access to ART, there are strong regional disparities, with a different distribution of public and private centers with agreements from north to south, long waiting lists, bureaucratic obstacles. “An impetus towards the dissemination of MAP courses – according to experts – could come not only from awareness campaigns on the issue of fertility and ART techniques, but also from the final approval of the interministerial decree that standardizes rates for assisted reproduction services throughout the country”.
AGING AND CHRONIC DISEASES
With the decline in the birth rate, the aging of the population is the factor that draws this “inverted pyramid” characterized by the prevalence in the population of the elderly (in Italy, a fifth of the population is over 65). “One of the major consequences – again emerging from the Organon event – is the growing impact of chronic non-communicable diseases (such as cardiovascular diseases, dyslipidemias, respiratory diseases, skin diseases, osteoporosis, osteoarticular diseases and migraines) responsible for 93.3% of deaths”.
Among the 55 year olds, one out of two individuals suffers from at least one chronic disease, whereas in the population over 75 the incidence increases: 9 out of 10 people live with a chronic disease in this age group. cardiovascular illnesses are those with the greatest impact in terms of lethality, with approximately 18 million deaths per year worldwide.
The theme of chronicity is associated with that of sustainability, to guarantee Quality care to all patients who need it and at the same time reduce the financial burden on public health. According to experts, one of the possible answers is offered by biosimilar drugs, biological drugs “absolutely comparable to originator drugs in terms of quality, safety and efficacy, but at a lower cost”.
THE BIOSIMILAR MEDICINES REPORT
Organon therefore supported the implementation of the report “Unlocking the potential of biosimilars”, an analysis that focuses on the current panorama of health policies on biosimilars in 17 countries, highlighting, for each country, the factors that determine success, ineffectiveness and areas of risk, to arrive at defining recommendations to ensure long term durability.
With regard to the situation in Italy, critical issues have arisen such as those related to the choice to “award tenders exclusively on the basis of price, an approach which does not take into account the HTA approach (for example, cost-effectiveness, introduction of quality criteria) and effectively triggers a race to lower the purchase prices of biosimilars, which could discourage companies from making them increasingly available”.
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