Axios International's 25th Anniversary

JOSEPH SABA, CEO, Axios International

Axios International completes 25 years of operation in 2022. What has been the key inspiration / vision that has helped the company grow?

The building of Axios International1 is very strongly connected with my experience of working with WHO, as part of the UNAIDS Drug Access Initiative. As a part of this initiative, I was in-charge of negotiating with pharmaceutical companies to launch one of the first antiretroviral (ARV) access programs in some of the emerging economies of the world which helped address the rising incidence of AIDS. Once these programs were successful, I realised that access would not be limited to just HIV treatment but in fact, should be used to address several unmet needs of people across different diseases. And with that vision, we founded Axios International in 1997. And ever since, our vision has remained the same – to enhance healthcare access for people across the world.

How has Axios International impacted the lives of patients over the last 25 years? What has been the company's global and, more specifically, Asian footprint till now?

At a global level, Axios International has reached more than 9 million patients over 100 countries in the last 25 years.

In the early days, we were only focused on supporting poor patients with access to healthcare, but we gradually realised that there is a large segment of middle-class people who are neither rich enough to buy medication nor poor enough to get donation. Over the years, we've tried to address the needs of this segment through innovative tools and personalised cost sharing programs. We strongly believe that simple price reduction or rebates are not the route to build healthcare access, and companies need to consider the entire treatment cycle, and constantly follow up with patients to ensure that they stay on treatment and benefit from optimum health outcomes.

In Asia, ageing populations and high healthcare needs demand that healthcare stakeholders work with each other so that their combined strengths can effectively address the diverse needs of people. Axios has always believed in multi-sectoral collaborations, and we look forward to working with Asian governments and other stakeholders to support people in the most effective manner possible. In fact, in Malaysia, we've a partnership with the National Cancer Society2 to ensure that cancer patients are comprehensively cared for , covering all aspects of treatment right from understanding of the disease, to access to healthcare and finally, to adherence for long term benefits. Apart from oncology, we also run a range of patient support programs in Asia that cover multiple therapeutic areas, including immunology, haematology, psychiatry, pulmonology and gastroenterology.

How do you define healthcare access and adherence and how do you ensure that your patient support programs can help achieve both?

Going back to my initial working days when I was a part of the UNAIDS program, I had a strong realisation that treatment plans only work if they are followed through by patients completely and are not left mid-way. This is the only way to maximise patient’s medical benefits. And so, this has been our guiding principle while working at Axios International throughout. We've always ensured that our patient support programs carried a critical component of patient follow-up. This component ensures that Axios is engaged with patients even after they leave the physical settings of a hospital or clinic leading to long durations of treatment cycles and hence, optimum health outcomes. In fact, some of our past studies have demonstrated that patients who are part of the Axios' programs have much longer treatment durations than even patients who are completely reimbursed, highlighting that a proper follow up with patients after they leave the hospital is key to delivering quality treatment.

What has also assisted treatment adherence is the development of scientific tools like Patient Needs Assessment Test (PNAT)3 by our team at Axios International. PNAT is an insightful tool that understands why certain patients drop out of treatment cycles, the various reasons beyond price affordability that can play an important role in impacting patient will to stay on treatment. This tool has further expanded the scope of our programs, ensuring that adherence is strongly ingrained in all our access solutions.

How big is the Axios family currently, and how do you ensure that all of them have a strong commitment towards building healthcare access?

Our Axios family has grown substantially over the years, and we have a strong team of over 200 employees today. We’ve our international offices located in Africa, Asia, Middle East, and Europe that work with healthcare stakeholders across the globe to ensure that we can support populations in most of the developing countries and emerging economies of the world.

While our teams have different areas of expertise but the one thing, they've in common is the commitment to empower people with healthcare access. We ensure that when we seek staff, we look out for this commitment in particular and as we work together, we further instil the spirit of this purpose through internal engagement. Patient-centricity or providing highest quality service to our patients has always been the motto at Axios International; our employees understand and practice it sincerely and all our patient support programs are designed accordingly.

Tell us about some of the key initiatives undertaken by Axios International that have helped the company improve patient experience while setting new benchmarks in the industry?

We’re proud that Axios International has always evolved over the years to build tools and systems that serve patients in the most effective manner, immaterial of where they are.

Our fundamental achievement is in the design and development of our patient support programs that are based on scientific analysis and are personalized for optimum outcomes. Unlike many players in the healthcare access space who seek to support patients through subsidies and short-term incentives, our programs take a comprehensive view of treatment plans and offer access solutions with the help of scientific and insightful tools like Patient Financial Eligibility Tool (PFET) and PNAT.

PFET is a unique confidential assessment tool that helps determine the true financial capability of patients by considering three key parameters – income, assets and standard of living. PFET ensures that we can offer treatments to a large community of patients who are neither rich enough to buy medication nor poor enough to receive donations. Based on this tool, we design our cost sharing programs where patients pay only a part of the treatment cost, and the rest is funded by other healthcare stakeholders in the ecosystem.

PNAT, on the other hand ensures that patients stay on treatment for longer durations, increasing their overall probability of improvement and full recovery. PNAT aims to understand the unique requirements of each patient across 5 key dimensions - social and economic, therapy related, patient related, healthcare team and system, and condition related aspects. It is used to understand and address the many barriers, patients and their families encounter daily as they strive to maintain optimal health.

Our other big initiative that has helped patients tremendously, especially during the ongoing pandemic, has been the offering of our digital healthcare solutions, Axios+4. We are in the digital age and we need to leverage this technology to better serve our patients. These tools have further helped us engage with patients after they leave the physical settings of a hospital and have allowed us to communicate and follow-up with them through their treatment cycle. It is after all, the follow-up with the patient which is of tremendous importance and plays a big role in them sticking to their overall treatment plan.

COVID-19 has exposed several inefficiencies within the healthcare sector in Southeast Asia and beyond. How did Axios respond to the pandemic and how did you ensure that your patients were looked after throughout?

In the middle of 2016, when we were working on our access and adherence solutions, we realised that a gap existed once patients left the physical settings of a hospital. Since patients were not in touch with healthcare providers anymore, there was no certainty that they would follow their treatment schedules as planned which could lead to suboptimal health outcomes. And that is when, we started working on our digital healthcare solutions to ensure that the engagement between Axios International and patients is continuous and unhampered.

As a result, when the COVID-19 pandemic struck the world, I'm proud to share that our patient support programs remained untouched, we looked after our patients just the way we were caring for them before, and there was no negative impact on their treatments. With the help of our digital solutions, our program managers ensured that we constantly communicated with our patients, that they received their treatments and there were regular follow-ups. In fact, COVID-19 illustrated the need to be in touch with patients in the space outside hospital settings and throughout their treatment journey, something that we at Axios International were anyhow doing through our programs.

What is the future of healthcare access in Asia and what role do you see Axios International playing in it?

Healthcare access will be strongly linked to reaching patients outside the hospital space going forward, and digtialisation will play a big role in achieving it. Also, access will not just be about making medication available, but it will focus on patients receiving their full course of treatment for optimum health benefits.

The healthcare sector will also need to prepare itself holistically to ensure that whenever next public health emergency strikes, we have all the resources to tackle it efficiently. We should be able to reach out to our most vulnerable patients and look after them in the most comprehensive manner.

The future of healthcare will also be about personalisation. We will see lots of personalised medicines being produced which will have to be matched with personalised treatment plans and follow ups.

Multi-sectoral collaboration is another area which will be important in the future of healthcare. No single stakeholder has the wherewithal to serve large communities of patients, partnerships between public and private sectors will gain more importance leading to the development of synergistic models which will strengthen healthcare access.

Finally, more relevant data will be needed to inform decision-making - data from access programs will provide breakthrough insights on the disease evolution, treatment, patients’ perceptions, outcomes and cost. Healthcare actors and professionals will need to explore approaches to capture accessrelated real-world insights (RWI) to better understand the impact of access interventions so that more efficient ones can be designed in the future.

I believe that Axios International will continue to play a dynamic role in the future of healthcare access. Equipped with our comprehensive patient support programs, strong adherence initiatives, digital healthcare solutions, our inclination for partnerships in global/ regional healthcare ecosystem and our investments in capturing RWI, we will always ensure that we serve our patients in the best possible manner. Going forward, we intend to widen our reach across Asia by expanding our patient assistance programs and by covering new chronic diseases to serve a wider spectrum of patients. Building sustainable healthcare access is our vision for Asia, and we will keep working towards it.

References:

1 https://axiosint.com/
2 https://cancer.org.my/
3 https://axiosint.com/adherence
4 https://axiosint.com/digitalsolutions

--Issue 56--

Author Bio

JOSEPH SABA

Joseph Saba is Co-Founder and Chief Executive Officer of Axios International, a global healthcare access company with approximately 25 years of specialised experience developing practical and sustainable solutions to patient access challenges in emerging markets. Under his leadership, the company has launched a number of successful drug access programs and developed innovative access strategies and new models for healthcare systems strengthening.

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