Img header logo

Society :

Efforts Made for Improving Access to Healthcare

Basic Policy

Even today as we see remarkable developments in the medical field, there are many diseases against which no effective treatment exists. Also, in low- and lower middle-income countries, there are many people who have difficulty receiving necessary medical care due to various reasons such as inadequate medical infrastructure and poverty.
Under the corporate philosophy “Dedicated to the Fight against Disease and Pain,” we aim to improve access to healthcare by pursuing these goals: the development of innovative pharmaceutical products and strengthening healthcare infrastructure.
We currently sell our pharmaceutical products ourselves in Japan, South Korea, and Taiwan.
We will make efforts to improve access to healthcare including the discovery of pharmaceuticals for rare diseases. In addition, we will strengthen our activities to provide new drugs to patients throughout the world, even in the U.S.A. and Europe, in addition to the regions of Asia.
We will also engage in medium- to long-term activities to strengthen the healthcare infrastructure in lower middle-income countries by such means as training of healthcare personnel and the development of healthcare infrastructure through partnerships with NGOs.

The Direction of our efforts

  • Promotion of research and development for measures against diseases for which patients’ medical needs are not yet met, rare diseases, and intractable diseases
  • Local medical education, training of medical personnel, improvement of medical supplies in countries and regions where medical infrastructure is not fully developed

Our Policies on Intellectual Property Rights and on Patents in Countries with Limited Access to Healthcare

We strive to continually develop innovative drugs through appropriate protection and use of various types of intellectual property generated during the course of drug development, while at the same time respecting intellectual property rights owned by third parties. In some countries, people have difficulty access to healthcare due to economic reasons. To deliver our innovative drugs to more patients worldwide, we will neither apply for nor enforce patent rights in Least Developed Countries defined by the United Nations*1 and Low Income Countries defined by the World Bank*2. We also will not file patent applications or enforce rights in Lower Middle Income Countries defined by the World Bank*3 with the exception of some countries.
In addition, we continue to examine applicability of our patented compounds to Neglected Tropical Diseases (NTDs) and other diseases in the aforementioned countries (use of the existing patent pool, the provision of voluntary licenses to generics manufacturers, etc.).
In the situation of a public health national emergency, such as a pandemic, etc., we understand that the compulsory right will be granted as one of the options. We also understand that the compulsory right will be granted in accordance with Article 31-2 of the TRIPS Agreement (the Agreement on Trade-Related Aspects of Intellectual Property Rights) in order to export pharmaceuticals to countries with insufficient or no capacity to manufacture pharmaceuticals. We will consider licensing patents flexibly and appropriately on a case-by-case basis. In order to improve access to pharmaceuticals, granting the compulsory right alone cannot resolve the fundamental problems. We consider that comprehensive activities are necessary, including activities that include the correction of economic discrepancies, training of healthcare professionals, and development of the healthcare system, healthcare infrastructure, and drug supply system.

Promotion Management System

We set the improvement of access to healthcare as a theme included in the materiality "respect for human rights" and the Board of Directors and the Management Meeting are managing targets and progress (Please click here for detail). In addition, in terms of implementation, the Sustainability Promotion Committee, consisting of members of each division, mainly promotes implementation under management by the Sustainability Strategy Meeting.

ONO PHARMACEUTICAL CO.,LTD., ONO PHARMACEUTICAL CO.,LTD., system

Examples of working on the creation of pharmaceuticals

Efforts made against rare diseases

Working on the treatment of rare diseases is important so as to improve access to healthcare. We make the following efforts to develop and provide pharmaceuticals for rare diseases.

(As of July31, 2023)

Product name Therapeutic indication* Date designated as an orphan drug Development Status
OPDIVO intravenous infusion Malignant melanoma June 17, 2013 Approved
Hodgkin lymphoma March 16, 2016 Approved
Malignant pleural mesothelioma December 1, 2017 Approved
Cancer of unknown primary March 11, 2021 Approved
Malignant mesothelioma (excluding malignant pleural mesothelioma) February 22, 2023 Filed
Unresectable advanced or recurrent epithelial skin malignancies May 23, 2023 Filed
Demser Capsules Improvement of catecholamine excess and various symptoms in pheochromocytoma May 25, 2015 Approved
Kyprolis for intravenous infusion Relapsed or refractory multiple myeloma August 20, 2015 Approved
Onoact for intravenous infusion Life-threatening refractory and emergent cardiac arrhythmias: ventricular fibrillation and hemodynamically unstable ventricular tachycardia August 24, 2016 Approved
Mektovi Tablets NRAS or BRAFV600 mutation-positive malignant melanoma December 4, 2013 Approved
Braftovi Capsules BRAFV600 mutation-positive malignant melanoma December 4, 2013 Approved
Velexbru Tablets Primary central nervous system lymphoma August 20, 2019 Approved
Waldenström's macroglobulinemia, Lymphoplasmacytic lymphoma November 19, 2019 Approved
  • Anticipated indications or diseases on the designation

Efforts to obtain approval for pediatric use

Medication evaluated appropriately for children should be used for pediatric patients. Aiming to improve pediatric patients’ access to healthcare products, we are working on the flexible approval for children as follows.

(As of July31, 2023)

Product name Therapeutic indication Status
Onon Dry Syrup Bronchial asthma, allergic rhinitis Approved
Emend Capsules Digestive symptoms (nausea, vomiting) resulting from the administration of antineoplastic agents (cisplatin, etc.) (including the delayed phase) Approved
Proemend for intravenous injection Digestive symptoms (nausea, vomiting) resulting from the administration of antineoplastic agents (cisplatin, etc.) (including the delayed phase) Approved
Orencia for intravenous infusion Active polyarticular juvenile idiopathic arthritis Approved
Demser Capsules Improvement of status of catecholamine excess secretion in patients with pheochromocytoma Approved
OPDIVO intravenous infusion Relapsed or refractory classical Hodgkin lymphoma Approved
Onoact for intravenous infusion Tachyarrhythmia (supraventricular tachycardia, atrial fibrillation and atrial flutter) in patients with low cardiac function Approved
ONO PHARMACEUTICAL CO.,LTD., ONO PHARMACEUTICAL CO.,LTD., system

Efforts for Improvement of the Medical Ecosystem
– Capacity Building –

There are still countries and regions in the world where the healthcare infrastructure is immature and many people who cannot access necessary healthcare are left behind. We are working to support NGOs to strengthen the healthcare infrastructure in these regions (local capacity building: Building a healthcare infrastructure where healthcare can be delivered continuously by local capabilities).

Under the "ONO SWITCH Project" that was implemented from FY2018 to FY2021, we have provided support in Cambodia, Myanmar, Bangladesh, and Bhutan for the training of local healthcare personnel, educating local citizens on diseases, and assisting with scarce healthcare facilities and supplies (for more details, see "ONO SWITCH Project (FY2018 to FY2022)" on this page below). We have achieved steady results in strengthening healthcare infrastructure through the activities of the NGOs and NPOs that we supported under this project.
In consideration of the lessons learned from this project, we started a new healthcare access improvement project, the "ONO Bridge Project," in FY2022.

With the new project, and not only through financial support necessary for NGO measures, we will also increase the social recognition of issues related to access to healthcare, have our employees participate in volunteer activities, take measures for collaboration using our know-how, etc. At the same time, we will increase the input of non-financial capital into the project and thereby maximize our social impact and strengthen our human resources, etc. For example, we will increase employee understanding, empathy, and desire to take on the challenge of resolving issues related to healthcare access and we aim to disseminate the mission statement and to increase engagement in the association thereto. In addition, we consider this project as to be an opportunity to broaden our understanding of patients and healthcare issues around the world and thereby aim to support our growth strategy

[figure] ONO Bridge Project (Bridging the healthcare access gaps)
Our thoughts on the project name:
To serve as a bridge between healthcare and patients.As the hope of patients for the future,we aim to create a society where people who need healthcare and people who want to deliver healthcare are connected and overcome the healthcare access gap.

In this project, we first started the two programs below with the NGOs with which we collaborate. Through the programs, we not only contribute to the financial support necessary for NGO measures but we will also increase the social recognition of issues related to healthcare access and take measures for collaboration using our know-how, among other things.

Myanmar: Maternal and child health service improvement program

logo
Partner
Specified Nonprofit corporation People's Hope Japan (hereinafter referred to as "PHJ")
photo
Corresponding SDGs
3.1
By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
Issues related to healthcare access in Myanmar and PHJ's activities

The maternal mortality rate in Myanmar is considered to be 250/100,000 live births (source: UNICEF, The State of the World's Children 2021). There is a big gap from the goal: "SDGs 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births." One of the causes is childbirth without assistance from healthcare professionals. In addition, the causes include a shortage of healthcare professionals, a shortage of appropriate devices at medical institutions, barriers to physical access, traditions of at-home childbirth, lack of community understanding of the risks associated with childbirth, etc. In addition, this issue is more significant in rural areas and there are differences in access to healthcare even within Myanmar.

Maternal mortality ratio(Per 100,000 live births)

graph

PHJ has engaged with this issue in Tatkone Township, Nay Pyi Taw Union Territory for approximately six years starting in 2014 and achieved results in promoting the use of maternal and child health services in rural areas. PHJ has been expanding the effective models obtained from this activity into Lewe Township Nay Pyi Taw Union Territory since 2020 (we have supported part of this activity).

  • Source: Extracted from PHJ Annual Report 2022

PHJ aims to increase four indicators (pregnancy check up rate, rate of proportion of births attended by medical practitioners, institutional births rate, and postpartum checkups rate) for which the use rate is particularly low in rural areas.

Percentage of maternal and child health services accessed in the target area (before the start of the program)

Programs that ONO supports
[Target area]

Target area: Lewe Township, Nay Pyi Taw

[Support period]

From FY2022 to FY2024

[Issues, measures, targets]
Issues
  • Lack of local people's knowledge of the risks of childbirth: Lack of appropriate knowledge of the risks associated with childbirth, such as hypertension due to pregnancy, postpartum bleeding, etc. leads to delays in identifying danger signs during pregnancy or at the time of childbirth and in deciding to see a hospital.
  • Difficulty accessing health services: There are significant differences in the use status of maternal and child health services between urban areas and rural areas. The network between local people and health services, such as midwives, etc., is insufficient.
MeasuresTraining and support for "maternal and child health promoters"
  • "Maternal and child health promoters" are volunteers. After they complete a two-day training session specified by the Ministry of Health, they provide health education and visit pregnant women in their homes, and they serve as a bridge between local people and health services under the supervision and instruction of a midwife. After the training, they cooperate with midwives and auxiliary midwives and collect information on pregnant women, postpartum women, and children below the age of 5 in their villages, visit pregnant women in their homes, support vaccination by midwives, prepare reports, and more.
  • This program trains maternal and child health promoters, monitors their activities, provides instructions, and provides re-training six months later.
Targets
  • Train new maternal and child health promoters: 600 promoters by FY2024
  • Provide re-training to trained maternal and child health promoters: 300 promoters by FY2024
    One maternal and child health promoter will be assigned per five pregnant women to all villages (178 villages) based on the approximate number of childbirths in one year.
[Progress of the program]
Program target FY2022 Status
Train new maternal and child health promoters
Target: 600 promoters by FY2024
  1. Trained 121 promoters.
  2. Selected 401 candidates for the next training.
  3. Provided training for instructors to 55 local healthcare professionals who instruct maternal and child health promoters.
On schedule
Provide re-training to maternal and child health promoters.
Target: 300 promoters by FY2024
Activity monitoring and instructions
Target: Every year
Activity status in FY2022

In FY2022, 121 maternal and child health promoters were trained (in 27 villages), which made a total of 181 promoters in combination with the previous project, the ONO SWITCH project. In addition, maternal and child health promoters are not selected by PHJ. Midwives, auxiliary midwives, and representatives of each village, etc. have mainly selected women who are trusted by villagers and are "expected to be a promoter." PHJ meets every single woman selected individually, explains the role of promoters and their specific activities, and confirms the consent of the woman. In FY2022, 401 candidates were selected in 98 villages.

Training for maternal and child health promoters is provided for two days by PHJ staff members and the health service bureau of Lewe Township together. In FY2022, training for instructors of maternal and child health promoters was provided to healthcare professionals so that maternal and child health promoters can be trained continually by local people even if PHJ's support will be ended in the future. 55 healthcare professionals who work at 45 health centers in rural areas underwent the training.

photo
Selection of maternal and child health promoter candidates
photo
Briefing to maternal and child health promoter candidates

Cambodia: Program to Improve Access to Advanced Pediatric Medical care

logo
Partner
Specified Nonprofit corporation Japan Heart
(hereinafter referred to as "JH")
photo
Corresponding SDGs
3.4
By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.8
Achieve universal health coverage (UHC), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all
3.c
Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
Issues related to Access to Healthcare in Cambodia and Activities of Japan Heart
photo
Name of the hospital
Japan Heart Children's Medical Center (JHCMC)
Year constructed
2016: JHCMC built
2018: JHCMC Expansion (increase in pediatric oncology beds)
Number of staffs
116(as of Aug., 2022)
Number of beds
94 beds(Adult: 39 beds/ Pediatric: 55 beds)
Diagnosis and treatment department
Internal medicine, Pediatrics, Obstetrics & Gynecology, Pediatric Hematology & Oncology, Pediatric Surgery
Performance
Provide medical care: Adult 16,569, Pediatric 3,274
Hospitalization: Adult 837, Pediatric 255
Surgery: Adult 844, Pediatric 219

The United Nations World Health Organization (WHO) has indicated that 80% of patients with pediatric cancer survive in high-income countries, while the percentage of patients who achieve remission in low- and middle-income countries is below 30%*.

Survival rate of pediatric cancer

graph

Many pediatric patients who cannot access advanced medical care have also been left behind in Cambodia.
A major cause is the shortage of medical institutions and healthcare professions that can provide advanced medical care. In particular, due to the impact of history, including the slaughter and civil war that occurred in the past in Cambodia, skilled medical care professionals who train the next-generation of medical care professionals are in short supply and issues related to healthcare access may remain in the future. In addition, the lack of economic power of people in the community, hospital visitation habits, and trust in healthcare are barriers to accessing healthcare.

Japan Heart opened the Japan Heart Children's Medical Center independently in the Ponnel District, Kandal Province, Cambodia, which provides advanced medical care for free to patients with pediatric cancer and other diseases. In addition, Japan Heart also trains local healthcare professionals through its activities. The Medical Center also engages in building the local healthcare system in the Ponnel District and provides free mobile medical services in the district.

  • In Japan there were 2.3 physicians per 1,000 people as of 2014, while in Cambodia, there were only 0.2 physicians per 1,000 people as of 2014. The number of general beds per 1,000 people is 13.1 beds in Japan, while it is only 0.9 beds in Cambodia in 2016*.
  • For example, at the Japan Heart Children's Medical Center, the medical fees for one patient with pediatric cancer are approximately eight hundred thousand to one million yen. The average annual income in Cambodia is 1,625 US dollars (approximately two hundred and twenty thousand yen; 2021, World Bank survey). Therefore, the standard treatment for pediatric cancer cannot be covered by an average household in Cambodia*.
  • There are only a few medical institutions that have a department specialized in pediatric oncology in Cambodia. In particular, the number of medical institutions that can provide expert treatment of pediatric solid tumors is very limited. Therefore, patients with pediatric solid tumors come to the Japan Heart Children's Medical Center from all over Cambodia.
Programs that ONO supports
[Target area]

Target area: Ponnel District, Kandal Province, Cambodia
In this program, we support the activities of "Japan Heart Children's Medical Center."

[Support period]

From FY2022 to FY2026

[Issues, measures, targets]
1. Training skilled healthcare professionals
Issues
  • In order for local healthcare professionals of Japan Heart Children's Medical Center to provide medical treatment without the support of Japanese staff and to train the next generation of healthcare professionals, it is necessary for them to accumulate more advanced and wider knowledge and experience. The Medical Center is one of the few facilities in Cambodia where healthcare professionals can experience advanced healthcare; however, clinical experience is limited at the Medical Center alone. In addition, the advanced healthcare that is provided at medical facilities and the environment in advanced countries cannot be acquired at the Medical Center.
  • Local nurses of the Medical Center have insufficient knowledge and skills to provide advanced nursing care (e.g., caring for patients who are under postoperative ventilator management, etc.).
  • The Medical Center has no local radiology technicians. Therefore, Japanese technicians are engaging in treatment, meaning that local technicians are not trained.
Measures
  • Training physicians:
    1. Provide training at a medical institution in Japan (National Hospital Organization Okayama Medical Center) in order to learn advanced medical care for pediatric patients (5 months).
    2. Expand the scope of clinical experience by providing training at other medical institutions in Cambodia.
    3. Create opportunities to learn the latest knowledge, such as participation in international academic conference of cancer, etc.
  • Training nurses:
    1. Provide clinical training for advanced healthcare mainly for postoperative management through training at other medical facilities in Cambodia.
    2. Create opportunities to learn the latest knowledge by participating in internal academic conference of cancer, etc.
  • Employing local radiology technicians: Employ local radiology technicians.
Targets
  • Training physicians:
    1. Training in Japan: 1 person
    2. Training at other medical facilities in Cambodia: 2 persons
    3. Participation in international academic conference of cancer: 5 persons
  • Training nurses:
    1. Training at other medical facilities in Cambodia: 5 persons
    2. Participation in international academic conference of cancer: 5 persons
  • Employing radiology technicians: 1 person
2. Improvement of access to healthcare in rural areas
Issues
  • There are public healthcare facilities, such as health centers, in rural areas in Ponnel District, Kandal Province and surrounding areas. However, the healthcare that can be provided is limited and patients do not regularly use the public healthcare facilities. In addition, there is a hospital with medical devices on site located at more than an hour’s drive away. Local people are not accustomed to visiting the hospital regularly and they do not fully trust medical care.
Measures
  • Japan Heart Children's Medical Center will give free mobile medical service to rural areas in Ponnel District, Kandal Province and surrounding areas and continue to provide necessary healthcare mainly for internal diseases to both adults and children.
Targets
  • Free mobile medical service: Monthly (The service will be provided 51 times during the program period, from January 2023.)
3. Enhancement of advanced medical devices
Issues
  • Japan Heart Children's Medical Center is one of few facilities that can provide advanced healthcare to pediatric patients in Cambodia; however, their medical devices are insufficient when compared with advanced countries.
  • There are issues where internal diseases (such as intussusception) cannot be diagnosed due to the absence of an X-ray fluoroscope or where there may be a greater burden on patients since a surgery requiring an X-ray fluoroscopy room is substituted with X-ray imaging machines.
Measures
  • Introduce an X-ray fluoroscope.
Targets
  • Purchase an X-ray fluoroscope and prepare an X-ray fluoroscopy room.
Progress of support programs
FY2022 Status
1. Training skilled healthcare professionals Training physicians in Japan One person completed the training. On schedule
Training physicians at other medical institutions in Cambodia
Training nurses at other medical institutions in Cambodia
Participating in international academic conference of cancer One physician and two nurses participated. On schedule
Employing radiology technicians Started recruiting activities
2. Improvement of access to healthcare in rural areas Free mobile medical service Conducted three times.
Provided free medical services to 143 persons.
On schedule
3. Enhancement of advanced medical devices Preparation of an X-ray fluoroscopy room Placed orders for devices.
Completed construction to renovate surgery rooms.
On schedule
Progress in FY2022
1. Training skilled healthcare professionals
  • Training physicians and nurses:
    1. Training physicians in Japan:
      1. One Cambodian physician received clinical training for 5 months at a medical institution in Japan. The physician has been working at Japan Heart Children's Medical Center as a pediatric surgeon since its opening and is expected to be a leader of Japan Heart's healthcare activities in Cambodia in the future.
      2. During the clinical training in Japan, the physician acquired a wide range of clinical experience, not only in pediatric cancer. After the training, the physician can engage in the management of pediatric surgery patients and patients with pediatric cancer and can make decisions on treatment policy with a higher level of leadership than before. The physician will accumulate surgery experience as a surgeon under the instruction of Japanese physicians at the Medical Center.
      photo
    2. Participation in international academic conference of cancer by physicians and nurses:
      1. One local physician and two nurses of Japan Heart participated in the St. Jude-VIVA Forum on Pediatric Oncology in Singapore. This forum is a place where pediatric tumor specialists in Asia gather and share their know-how and implement networking to fill the gap between advanced countries and developing countries. At the Nursing Symposium, nurses of Japan Heart presented their activities. It became an opportunity for them to discuss their activities using their own words and they learned a lot and were stimulated by the exchanges with many healthcare professionals.
      photo
  • Employing radiology technicians: Recruiting activities of local technicians have started. Since SNS is a main source for searching recruiting information in Cambodia, recruiting activities were mainly conducted using SNS and inquiries to educational institutions were also made. Educational institutions that train radiology technicians are limited in Cambodia and human resources are also limited. Therefore, recruiting is not easy. Recruiting activities will also be continued in various ways in the following fiscal year.
2. Improvement of access to healthcare in rural areas
  • Free mobile medical services: Mobile medical service was conducted three times in Ponnel District and the surrounding area (an area which is a three-hour drive from the Japan Heart Children's Medical Center) and provided free medical treatments to 143 local people. Lifestyle-related illness were found with many patients who came for medical examination. Diagnoses, such as diabetes, high blood pressure, and gastroenteritis, were given and therapeutic agents were prescribed. They were encouraged to continue visiting local medical institutions. In addition, it was found that knowledge on pediatric nutrition management is lacking. There are children with smaller bodies than usual. Nutritional guidance is also provided to their parents.
photo
photo
3. Enhancement of advanced medical devices
  • In order to install a surgical X-ray machine (C arm), construction to expand an operation room was conducted in FY2022. Lead sheets were attached to the wall so that X-rays do not leak outside the room and a special door was installed. An X-ray machine will be introduced in FY2023.
photo
ONO SWITCH Project from FY2018 to FY2021

We engaged in the ONO SWITCH Project from FY2018 to FY2021 as an initiative to promote both medical system support and work style reform. Under this initiative, donations are made to the medical-related NPOs/NGOs mentioned below who use the money saved by reducing overtime payments through the promotion of our work style reform. The project aims to contribute to the promotion of work style reform, healthcare, and people’s health around the world, thereby further promoting our corporate philosophy “Dedicated to the Fight against Disease and Pain.”

—Project name and concept—
Save the World by our work style ImprovemenT and CHange
The project name also expresses switching working styles, switching the funds obtained through work style reform to donations, and switching in the process of reviewing our working styles.
Please see the results for each fiscal year below.
ONO PHARMACEUTICAL CO.,LTD., ONO PHARMACEUTICAL CO.,LTD., system

Participation in Access Accelerated Initiatives

Since 2023, ONO has been participating in Access Accelerated, a global partnership that aims to improve access to non-communicable diseases (NCDs) prevention, treatment, and care in low- and lower-middle income countries.
Access Accelerated is an international initiative which was established at the World Economic Forum in 2017. Its member companies consist of more than 10 pharmaceutical companies in Japan, the United States and Europe. In partnership with organizations such as the World Bank Group, Access Accelerated is working to achieve one of the United Nations' Sustainable Development Goal (SDG) targets, namely “By 2030, reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and well-being” in low- and lower-middle income countries.
For more information on Access Accelerated activities, please visit the following website.
https://accessaccelerated.org/

ONO PHARMACEUTICAL CO.,LTD., ONO PHARMACEUTICAL CO.,LTD., system