Bristol Myers lines up Opdivo treatment in Pakistan, Rwanda and beyond as part of 10-year access campaign

When it comes to supporting cancer care and other therapeutic approaches in low- and middle-income countries (LMICs), Bristol Myers Squibb is taking a long-term view.

In its quest to reach more than 200,000 patients with its medicines in LMICs by 2033, BMS on Wednesday said it's embarking on a new 10-year effort to bolster access.

One cornerstone of the plan involves BMS’ collaboration with the Access to Oncology Medicines (ATOM) Coalition, which BMS joined as a founding supporter back in 2022. Now, working with ATOM and its partners, BMS aims to roll out an access model for its cancer fighter Opdivo in "select countries," including Pakistan, Rwanda, Zambia.

BMS says it will also work to develop an integrated pathway to expand Opdivo access in multiple other LMICs by 2026.

Beyond immuno-oncology, BMS says it has introduced local brands of many of its drugs in LMICs to help address affordability issues and cut the lag time between availability of its drugs in higher- and lower-income countries.

For instance, Bristol said it filed for 11 drug approvals in LMICs in 2023; five were granted approvals.

As part of its 10-year plan, BMS plans to utilize "direct import" and "direct-to-institution" distribution pathways in countries where it lacks a commercial presence.

Through the direct import approach, BMS is granting access to 12 medicines in more than 80 LMICs via a tiered pricing structure. The direct-to-institution (DTI) pathway, meanwhile, relies on collaborations with local treatment partners.

The company’s initial DTI efforts center on Pakistan, Kenya, Uganda, Tanzania and Zambia, a BMS spokesperson said. The company is exploring or setting up DTI partnerships in another 6 countries.

BMS' latest global access move is not entirely unusual among large pharma players.

In late 2022, AstraZeneca made a similar play with its "Accelerating Change Together for Cancer Care in Africa" project, which provides a platform for partners to usher in advances in local cancer care. The program, which is led by a steering committee of doctors, oncology institutions and advocacy groups, aims to improve care by focusing on early screening and diagnosis, patient empowerment and more, AZ said at the time.

Elsewhere, a host of drugmakers signed on with ATOM when the coalition launched in 2022, including AstraZeneca, BeiGene, Gilead Sciences, Novartis, Roche, Sanofi and Teva. In one of the first access moves by a coalition member, Novartis at the time said it would license its blockbuster chronic myeloid leukemia therapy Tasigna to the Medicines Patent Pool (MPP).

Last summer, the effort took another step forward as MPP enlisted four generic drug makers to produce copycat versions of Tasigna. The agreement allows Indonesia's BrightGene and three Indian manufacturers—Dr. Reddy’s, Eugia and Hetero—to produce generic Tasigna in six countries—Egypt, Guatamala, Morocco, Pakistan, the Philippines and Tunisia—and supply it to 44 territories.