Product Development

While access to healthcare remains a challenge worldwide, it also provides an opportunity for companies to deliver healthcare solutions specifically for those at the “base of the pyramid” (BoP)¹ who have limited access to the healthcare market due to product affordability, lack of medical infrastructure and/or logistical limitations. While Baxter has worked in emerging economies for numerous years, developing products particularly suited to those at the BoP is an emerging area of its sustainability and business strategy.

In 2008, Baxter began to analyze its portfolio to identify existing products as well as product development opportunities to meet the needs of these populations. Current products particularly well suited to emerging economies and potentially to the BoP have the following characteristics: long shelf life, little or no required refrigeration, low dependency on healthcare infrastructure (such as hospitals, clinics and skilled medical staff), non-complex technology and low cost. In 2009, Baxter will develop a list of the highest potential product opportunities and assess the feasibility of making those products more accessible.

Baxter also assessed R&D investment levels in this area in 2008, which will help the company set targets to increase future spending.

Examples of existing products that are especially well-suited to the needs of emerging economies include:

Peritoneal Dialysis

Baxter is the world’s leading developer, manufacturer and marketer of peritoneal dialysis (PD) products for end-stage renal disease, or kidney failure. PD is a self-administered therapy that, unlike hemodialysis, does not require an extensive infrastructure of hospitals or clinics. Evidence shows that PD home therapy, especially continuous ambulatory peritoneal dialysis, is generally less expensive to payers than in-center hemodialysis. This offers potential cost benefits as well as an improved quality of life for many patients, particularly in emerging economies where many people with kidney disease go untreated due to cost and lack of infrastructure. Baxter works with governments to institute adequate reimbursement for PD therapy and strives to make it cost-effective and accessible through local manufacturing, home delivery and product innovations.

Baxter also educates clinicians and patients about all treatment options, as numerous patient education research studies show that many patients with end-stage renal disease (ESRD) who actively participate in decisions about their therapy achieve better health outcomes and adherence to treatment plans. In the United States, Baxter Kidney Patient Educators (KPEs) provide newly diagnosed ESRD patients with information about the disease as well as one-on-one emotional support. Baxter’s KPEs have worked with more than 80,000 patients since the program was founded in 1997.

Ready-to-Deliver Devices

Baxter sells pre-formulated, non-proprietary drugs in ready-to-deliver devices, including intravenous (IV) solutions and pre-filled syringes. Such drugs – most of which appear on WHO’s list of essential medicines – are sold at lower prices than branded drugs. Pre-mixed and pre-packaged ready-to-deliver drugs also can increase provider efficiency and reduce contamination risk. Baxter’s pre-mixed IV solutions avoid the need for caregivers to draw a drug from a vial and inject it into an IV container, reducing the risk of contamination.

Supporting Pandemic Preparedness

Pandemic preparedness planning continues to be a focus of global public health authorities. Pandemics do not occur frequently. However, when they do they can have significant consequences both in human morbidity and mortality and in social and economic disruption. With the emergence in recent years of both avian influenza and SARS, an increased intensity has been put behind the development of pandemic preparedness plans. And with the recent identification of an emerging novel A/H1N1 strain, these plans are now being tested. Baxter is assisting in this area in two significant ways.

First is in the development of a pandemic influenza vaccine. Baxter continues to aggressively pursue pandemic influenza vaccine development using its unique Vero cell technology. The technology can produce influenza vaccine more quickly than traditional production methods, enabling the company to produce large quantities of vaccine rapidly in the event of a pandemic. Using this Vero cell technology, Baxter received European Medicines Agency (EMEA) approval in early 2009 for a mock-up pandemic vaccine called CELVAPAN, the brand name for the company’s pandemic influenza vaccine.

The CELVAPAN EMEA licensure allows for fast track approval of a pandemic influenza vaccine containing an actual pandemic strain once the World Health Organization (WHO) has declared an actual pandemic. The qualification, development and manufacturing processes used in gaining mock-up licensure for CELVAPAN are being applied as Baxter develops a pandemic vaccine for the emerging novel A/H1N1 influenza strain.

Secondly, Baxter works with global public authorities worldwide in support of their pandemic preparedness planning. Baxter provides reserve production capacity to governments in advance of pandemics and supplies pandemic vaccine to public health agencies as stockpiles for use once a pandemic is declared. Baxter also manufactures pandemic vaccine for public health agencies once a pandemic is declared by WHO. Many public health agencies have agreements with Baxter for supplies of pandemic vaccine under these scenarios. In addition, Baxter is committed to working with WHO to allocate a portion of the company's commercial pandemic vaccine production to address global public health issues deemed most urgent.

Baxter takes its responsibility to continue the timely flow of Baxter products to customers very seriously – including in times of adversity such as a pandemic. In 2005, the company established a system to prepare for, manage and recover from situations that have the potential to interrupt normal business operations. Teams at the global, regional, country and facility levels continue to review potential threats and meet regularly to minimize the risks of business interruption.

¹ The term “base of the pyramid” refers to the roughly four billion people who live on less than $4 per day per capita, mostly in developing countries. Many companies have typically developed and marketed products and services for people at the “top of the pyramid.” In recent years, more companies have extended product and service offerings to the “middle of the pyramid,” often referred to as an “emerging economy” strategy.