Our commitment to providing access to reproductive health starts with our research and development, which has resulted in a diverse portfolio of contraceptive products.
Beyond our research, we continue to work hard to develop sustainable business models that will help improve access to our products for the people who need them most. Our partnerships with governments, international organizations and nongovernmental organizations (NGOs) help support and implement programs and policies that improve access and promote capacity-building by helping to train health care professionals and address barriers to care.
Research & Development
We have a strong legacy of research and development of contraceptive products that have supported women’s family planning efforts. Over the years, we have been responsible for the development of a wide range of contraceptive options, including a single-rod contraceptive implant, a once-monthly vaginal contraceptive ring, and progestin-only and combined oral contraceptives.
In 2015, our researchers continued to develop new formulations of our existing women’s health products to better meet conditions in developing countries.
Sustainable Business Model to Promote Access
We are committed to making our contraceptive products available to women around the world. We take a comprehensive approach to access that includes high-quality manufacturing and supply chain management; extensive registration and World Health Organization (WHO) prequalification for a wide variety of our family-planning products; responsible commercialization that incorporates training and capacity-building; policy advocacy; and community investment.
In developing countries that have high rates of maternal mortality and low rates of contraceptive prevalence, we have created a sustainable business model to promote access to contraceptive health programs. These activities are focused primarily on sub-Saharan Africa and countries in Asia and Latin America with high unmet need. Through this model, we work closely with core global partners and their regional and local affiliates─including UNFPA, USAID, Marie Stopes International, the International Planned Parenthood Federation, DKT International, the Clinton Health Access Initiative, the Bill & Melinda Gates Foundation and Population Services International─to help expand access to our products.
High-Quality Manufacturing & Supply Chain Management
We work to ensure that we have sufficient manufacturing capacity to meet short-, medium- and long-term availability of our contraceptive products for reproductive health programs conducted by governmental organizations, NGOs and other customers.
We continuously examine our supply chain seeking to reduce inefficiencies, optimize yields and lower costs of production, and have passed these savings on to our customers in the form of lower prices, particularly in lower-income markets. We also invest in new technologies to increase the efficiency of our operations and to be able to produce more affordable products at the same high quality to meet increasing demand.
Registration & Prequalification
We seek to ensure global access to our contraceptive products by obtaining and maintaining up-to-date product registrations around the world. In addition to existing and in-process registrations, numerous registrations are planned for products in countries of various income levels.
The following metrics are for our family planning products intended for underserved segments of the world’s poorest countries (defined as Family Planning 2020 or FP2020 countries) that are supplied through the public sector and social-marketing organizations. In 2015, IMPLANON NXT® (etonogestral) was approved in several FP2020 countries including, but not limited to, Bangladesh, Ethiopia, Madagascar, Sudan, Tajikistan and Uganda.
Note: For World Bank country classifications, please click here.
In order to facilitate institutional purchases of family planning products and provide quality assurance, we have secured WHO prequalification for EXLUTON (lynestrenol), IMPLANON (etonogestrel implant), IMPLANON NXT (etonogestrel implant) and MARVELON 28 (desogestrel-ethinyl estradiol).
The success of reproductive health programs in the developing world relies upon the close cooperation and coordination of many partners. They include pharmaceutical companies like ours that discover, develop and manufacture contraceptive products; national governments that seek to support family planning through policies that increase the use of contraception and through investment in both procurement and capacity-building; international, bilateral and multilateral donors that finance the purchase of reproductive health commodities and invest in service delivery management and implementation; NGOs that support implementation of such programs; and health care professionals and health extension workers who counsel and provide care for women around the world.
As one of many partners, we take the following steps (details below) to support family planning programs and to help increase awareness of and access to a broad choice of contraceptive products:
- Requests for quotation
- Partnering for implementation
- Public advocacy
Requests for Quotation
Our company receives and responds to “Requests for Quotation” from developing countries’ governments seeking supplies for their own programs (financed by government funds, by multilateral organizations like the World Bank or through bilateral aid); from donor country aid agencies (e.g., the U.S. Agency for International Development [USAID], the U.K. Department for International Development [DFID], and KfW, a German government-owned development bank) seeking to purchase reproductive health commodities that will be donated to programs in one or more countries; from multilateral agencies, such as the United Nations Population Fund (UNFPA), donating to one or more countries; or from nongovernmental agencies seeking supplies for programs that they manage in one or more countries.
In responding to these requests, we adhere to the specific guidelines of each proposal and acts in full compliance with local and international laws and requirements.
For contraceptive product pricing, we consider a nation’s level of economic development and other relevant factors, including the types of family planning programs implemented by the local government.
In upper-middle-income and high-income countries, we provide our products at prices that take into account the innovation and value they represent. With a commitment to making our contraceptive products available to the public sector, we also offer discounts to organizations that serve women of all income levels, like Planned Parenthood affiliates, so that the women who rely on their services have routine access to contraceptive options that include nondaily and long-acting reversible methods.
We believe that our pricing approach will help improve product availability while also allowing the company to continue to invest in research, development, production, and the training and education necessary to help ensure appropriate counseling on and use of our products.
We are extending our access pricing to targeted countries through 2023, an additional five years beyond the expiration of our 2013 agreement.
In May 2013, our company and a group of public- and private-sector partners announced an agreement to expand contraceptive access and options for millions of women in some of the world’s poorest countries. Under the agreement, we reduced the cost of IMPLANON and our next-generation implant, IMPLANON NXT (by approximately 50 percent for the next five years (through 2018) in the targeted poorest eligible countries of focus for the reproductive health community. Learn more.
Since 2013, the number of IMPLANON and IMPLANON NXT implants provided to countries under the agreement has doubled, bringing greater choice to millions of women in the world’s poorest regions.
In November 2015, we announced our decision to extend our access pricing to these same targeted countries through 2023, an additional five years beyond the expiration of the 2013 agreement. Learn more.
Partnering for Implementation
For family planning programs in the developing world involving our contraceptive implants IMPLANON and IMPLANON NXT, the company requires the recipient governments and partnering NGOs to sign its Cooperation Agreement for the Receipt and Use of IMPLANON (CARUI). The cooperation agreement includes:
- Our commitment to a comprehensive service approach that provides and/or supports capacity-building in service delivery, including pre- and post-insertion counseling and insertion/removal training
- Distribution requirements that must be met by our company and local partners to ensure that all clinics/providers meet training and quality assurance requirements, provide sustained services over the duration of the product’s life (three years) and can access referral centers in case more specialized care related to IMPLANON is required
- Our commitment to “training of trainers” and providing training materials, including audiovisual materials, training kits, artificial arm models and placebos; we may provide additional technical assistance for direct and cascaded training activities by health care providers with our local partners on a case-by-case basis
- Procedures to report product complaints and adverse events
- Provisions regarding compliance with the applicable laws of the U.S. and the recipient country, and our ethical and business compliance policies
In the countries where our products are included in family planning programs, we work closely with ministries of health and local implementing partners, who play a pivotal role in supporting training, counseling and other related activities. Our local implementing partners have included Jhpiego, EngenderHealth, Clinton Health Access Initiative, Marie Stopes International (MSI), International Planned Parenthood Federation (IPPF), Population Services International, DKT and Pathfinder International. Such collaboration ensures that countries have the expertise and support they need to achieve their reproductive health objectives.
In February 2015, we announced, as part of our commitment to health care provider training, that we would provide IMPLANON NXT placebo training applicators at no cost in FP2020 countries. During 2015, we provided approximately 75,000 placebos. We have also committed to providing placebos at no cost in these countries through 2017.
In 2015, we worked with more than 42 countries in sub-Saharan Africa, Asia and Central America to provide contraceptive products through numerous partnerships with governments, donors and NGOs. Some of the countries we engaged with included Madagascar, Ethiopia, Kenya, Uganda, Tanzania, Nigeria, South Africa, Honduras, Somalia, South Sudan, Yemen, Pakistan, Cambodia and Bolivia.
In 2015, we worked with partners in innovative ways to further expand awareness and access and strengthen health systems. For example:
- In Kenya and the Democratic Republic of Congo, we worked with the government and local stakeholders to shine a spotlight on the need for improved access to family planning for adolescents. Attendees from both workshops are now developing action plans.
- In Nigeria, we provided support to the Human Network International for the development of a free, on-demand Information Service via mobile phones. The service provides information on health, agriculture, microfinance, family planning, and land tenure in the local language.
- In the Philippines, we worked with the Department of Health (DOH) to design and develop a family planning registry that now serves as a data collection tool to support the government’s measurement of contraceptive prevalence rates, method effectiveness, and commodity utilization among others. Ultimately, the software can be integrated into the government’s existing database management system and can help health care providers with client follow-up, referrals and adverse event reporting.
Providing Hope in the Aftermath of Tragedy
The small land-locked country of Nepal is home to more than 27 million people. Most Nepali people live in remote villages that are difficult to reach and lack public health services. As a result of these challenges, the landlocked country in South Asia faces several major health issues, including high rates of maternal mortality and unmet need for family planning.
In March 2015, the government of Nepal pledged to reposition family planning to foster sustainable social and economic development and to address barriers to accessing family planning services faced by individuals and couples, including adolescents and youth, those living in rural areas, migrants and other vulnerable or marginalized groups. The government also pledged to broaden the range of modern contraceptives available and to engage in a range of communications and media activities to raise awareness of family planning among populations with a high unmet need for modern contraception, focusing particularly on adolescents and young people.
Less than one month after this historic commitment, tragedy struck; Nepal experienced a massive earthquake that killed more than 8,000 people and injured more than 21,000. The effect of the earthquake and its aftermath was most pronounced on those in rural communities.
Recognizing that help was needed, Sunualo Parivar Nepal (SPN), the implementing partner of Marie Stopes International (MSI) Nepal, set out three months after the earthquake to train providers on the use of long-acting contraception and to equip them with the skills to travel to remote areas to provide services to women in need. SPN/MSI Nepal is also supporting the Family Health Division (FHD) in conducting a pilot survey to test feasibility and acceptability of Implanon NXT among women in Nepal. Our company assisted in the master training program for 12 service providers organized by SPN/MSI Nepal on single rod contraceptive implant (Implanon NXT) including technical update on contraceptives, client assessment and counselling for long acting contraceptives. This pilot study is funded by UNFPA Nepal and is being implemented by SPN/MSI Nepal under the leadership of FHD.
We support the ambitious but, we believe, achievable goal set by the public health community in 2012 of ensuring that voluntary lifesaving family planning information, services and products reach an additional 120 million women and girls in the world’s poorest countries by 2020.