Kenya Financial Assistance Programs Market Analysis

Kenya Financial Assistance Programs Market Executive Summary

The Kenya Financial Assistance Programs Market is at around $19.8 Mn in 2023 and is projected to reach $55.1 Mn in 2030, exhibiting a CAGR of 15.7% during the forecast period 2023-2030.

The aim of drug manufacturers' patient financial support is to minimize or remove out-of-pocket cost sharing as an obstacle when patients choose medications, thereby keeping them on brand-name drugs for longer. Co-pay assistance, free drugs trails, bridge programs, sliding scale programme, Coupons, Bulk purchasing programs etc are some of the widely used financial assistance programme under patient assistance programs. Patients' out-of-pocket drug cost sharing is determined by their health plans or pharmacy benefit manager's (PBM's) formulary--a list of preferred and nonpreferred prescription drugs. Preferred status is based on a drug's effectiveness, price, and the level of rebate the payer receives from the manufacturer for giving the drug preference over its competitors. Generics and preferred brand drugs are generally assigned lower patient cost sharing than nonpreferred brand drugs. As drug prices have increased, so has patient cost sharing, causing some patients to stretch, forgo, or discontinue medication that is too expensive. Drug manufacturers often seek to mitigate these effects by providing or funding various forms of patient financial support.

There is an increasing prevalence of chronic diseases in Kenya, with prevalence rate around 3% and total number of cases are 821,500. Therefore, the market is predominately driven by factors such as rising prevalence of chronic diseases, and rising drug cost, whereas factors such as

Pharmaceutical companies providing financial assistance to patient are such as Abbott, AstraZeneca, AbbVie Merck, GSK, Pfizer, Johnson & Johnson, Novartis among others.

Market Dynamics

Market Drivers

Rising drug costs: Specialty and innovative drugs, particularly for rare diseases or complex conditions, are becoming increasingly expensive. This trend leads to higher out-of-pocket costs for patients, even those with insurance. As a result, more patients need financial assistance to access their prescribed medications.

Chronic disease prevalence: There is an increasing prevalence of chronic diseases in Kenya, with prevalence rate around 3% and total number of cases are 821,500. The increasing number of patients with chronic conditions necessitates long-term, often expensive treatments. This creates a sustained need for financial assistance over extended periods. Chronic disease management is a priority in healthcare, driving support for assistance programs.

Market Restraints

Regulatory constraints: Anti-kickback laws restrict how pharmaceutical companies can organize their assistance programs. These rules are intended to prevent undue influence on prescribing choices but can complicate program design. Adhering to these regulations raises operational costs and adds complexity for program managers.

Insurer Resistance: Some insurer’s view assistance programs as disrupting their formulary strategies and cost-control efforts. There is a growing trend where insurers exclude copay assistance from counting toward deductibles (copay accumulator programs), potentially reducing the impact of these programs for certain patients.

Budgetary pressures: Pharmaceutical companies must weigh the expenses of assistance programs against maintaining profitability. Economic challenges or shifts in business strategy could result in reduced funding. This may lead to more selective or limited support options.

Regulatory Landscape and Reimbursement Scenario

The Pharmacy and Poisons Board (PPB) is the primary regulatory body for pharmaceuticals in Kenya. Established under the Pharmacy and Poisons, the PPB regulates the practice of pharmacy and the manufacture and trade in drugs and poisons. The Board aims to implement regulatory measures to ensure the highest standards of safety, efficacy, and quality for all drugs, chemical substances, and medical devices, locally manufactured, imported, exported, distributed, sold, or used, to protect the consumer.

The PPB is responsible for various functions, including the registration and listing of medical products, inspections and licensing of manufacturing premises, importing and exporting agents, wholesalers, distributors, pharmacies, and other retail outlets, and post-market surveillance to monitor the safety and efficacy of medicines after they are approved and released into the market. The PPB also regulates the import and export of controlled substances, including narcotics, psychotropic substances, and precursor substances, in line with the requirements of the International Narcotics Control Board (INCB) and the three International Conventions.

The PPB does not have a direct role in reimbursement, but the Ministry of Health is responsible for the procurement and distribution of medicines in the public sector. The Ministry aims to increase medicine availability in public health facilities to reduce the demand for medicines in the private sector, which can lead to the purchase of substandard or falsified medicines.

Competitive Landscape

Key Players

Here are some of the major key players in the Kenya Financial Assistance Programs Market:

• AbbVie
• AstraZeneca
• Abbott
• Eli Lilly
• Roche
• Pfizer
• Sanofi
• Novartis
• GSK
• Johnson & Johnson