Equitable Access to Monoclonal Antibodies for Low- and Middle-Income Countries (2024-2025)
Over the 2024-2025 academic year, an interdisciplinary Bass Connections team investigated how pricing and demand for monoclonal antibodies, a class of biologically engineered therapies, influence their availability and uptake in low- and middle-income countries. Building on a summer literature review, the team refined its focus to trastuzumab, a first-line treatment for HER2+ breast cancer, and selected South Africa and India as case studies. The research aimed to identify both country-level and industry-level barriers to access, including cost, financing and market incentives, while exploring potential strategies for expanding availability.
The team conducted a stakeholder analysis and engaged with an expert advisory group to identify stakeholders in each country to interview on the barriers of access to trastuzumab in South Africa and India. The team developed a semi-structured interview guide and invited over 90 different stakeholders to participate in virtual interviews. The team members successfully completed interviews with 9 key informants, including perspectives from both countries and various sectors such as healthcare providers, academics, manufacturing experts and civil society. Members of the team developed a code book to analyze the transcripts from the interviews and then conducted a thematic analysis to identify key themes and findings.
Findings were shared through poster presentations at the Mary Ann Black Health Equity Symposium and the Bass Connections Showcase, as well as at the Duke-Margolis Health Policy Seminar and in discussions with the advisory group. The project is culminating in a final paper that synthesizes the research and proposes recommendations for improving access to trastuzumab in similar contexts. The team is exploring publication options to extend the reach and policy impact of its work.
Timing
Fall 2024 – Spring 2025
Team Outputs
Barriers to the Introduction and Uptake of Trastuzumab for Breast Cancer in South Africa and India: Insights from Country and Company Perspectives (Poster presentation at Fortin Foundation Bass Connections Showcase, April 16, 2025)
Poster presentation (Mary Ann Black Health Equity Symposium, February 7, 2025)
Presentation of research (Duke-Margolis Health Policy Seminar)
Image: A digital 3D representation of the West Nile virus in complex with the Fab fragment of a neutralizing monoclonal antibody, by NIH Image Gallery, licensed under CC BY-NC 2.0