Biosimilars: Balancing Care Quality and Cost Control in Morocco

The recent confrontation between Fouzi Lekjaa, Minister Delegate in charge of the Budget, and major pharmaceutical companies, as reported by TelQuel, illustrates a decisive turning point in Morocco's health policy. At the heart of the debate is the issue of high medicine prices and their impact on access to care for the population. The recent meeting between Lekjaa and the CGEM (General Confederation of Moroccan Enterprises) highlights the urgency of structural reforms to address challenges of accessibility and financial sustainability.

In this context, the role of biosimilars - alternatives to costly biological medicines - appears to be a strategic opportunity for Morocco.

1. A Favorable Context for the Adoption of Biosimilars

The meeting between Lekjaa and the CGEM highlighted the need for better regulation of medicine prices and a reduction in the excessive margins applied by some pharmaceutical companies. According to the minister, more than 30% of the AMO budget is devoted to medicine reimbursement, threatening the financial viability of the system. Lekjaa pointed to excessive margins in the pharmaceutical industry, reaching as high as 300% for some imported medicines. This situation is not unique to Morocco: many African countries face similar challenges, where high medicine costs weigh heavily on public health systems.

The example of amoxicillin, the best-selling antibiotic in Morocco, illustrates this issue perfectly. While the raw material is imported from China at a cost ranging from 800 to 1,000 dirhams per kilogram, the public price in Morocco reaches 4,000 to 4,500 dirhams, raising questions about cost transparency and the margins captured by sector players.

2. Biosimilars: An Affordable Economic Solution

Biosimilars offer a response to these issues by providing less costly alternatives to biological medicines, which are often inaccessible for many patients. According to the report Act4Biosimilars Regional Deep Dive Middle East and Africa, by 2027, biological medicines worth $1.6 billion are expected to lose exclusivity in the Middle East and Africa (MEA) region, opening the way for more affordable biosimilars.

Biosimilars are near-identical copies of reference biological medicines, developed once the original medicine's patent has expired. These alternatives can reduce costs by an average of 15% to 30% compared with their biological counterparts, while maintaining equivalent efficacy and safety.

In September 2024, the Moroccan Pharmaceutical Industry Association (AMIP) announced that it had joined the International Generic and Biosimilar Medicines Association (IGBA) as an associate member. This integration marks an important step in promoting access to generic and biosimilar medicines worldwide, thereby strengthening Morocco's potential to become a major regional player in this sector.

The adoption of biosimilars offers several advantages for Morocco:

• Reducing health expenditure: Biosimilars can ease public and private health budgets, allowing resources to be reallocated to other health priorities. Example: in South Africa, although access remains limited, biosimilars have helped reduce treatment costs in the private sector.
• Improving access to treatment: By making treatments more affordable, biosimilars can increase the number of patients treated, particularly for serious conditions such as cancer or autoimmune diseases.
• Strengthening pharmaceutical independence: Morocco could follow the example of the agreement signed between the Mohammed VI Foundation and Sothema to produce generics and biosimilars locally, which would reduce dependence on imports.

International examples:

• In Europe, biosimilars have helped reduce treatment costs for chronic diseases such as diabetes, cancer and autoimmune diseases. For example, the introduction of biosimilar insulin led to price reductions of 20% to 30% in several countries.

3. Challenges to Overcome for Successful Adoption

For biosimilars to truly play their role in reducing health costs, several obstacles need to be overcome:

• Regulation: Morocco needs to adopt clear and appropriate regulations to assess, approve and market biosimilars quickly while guaranteeing their quality. Egypt's example, with an accelerated registration pathway, could serve as a model.
• Education and awareness: Health professionals and patients need to be informed about the benefits of biosimilars to encourage acceptance.
• Local development: Investing in national production capacity is essential to reduce costs and ensure continuous availability. In this regard, local partnerships such as the one signed between Sothema and the Mohammed VI Foundation are promising.

4. An Opportunity for Morocco and Africa

Morocco's experience could serve as a model for other African countries facing similar medicine-access challenges. By positioning itself as a regional leader in biosimilar adoption, Morocco could:

• Attract foreign investment into the pharmaceutical sector.
• Strengthen cooperation with African countries to share good practices.
• Promote a pan-African strategy to reduce the costs of biological treatments.

Conclusion: A Transformation to Encourage

The meeting between Fouzi Lekjaa and the CGEM marks a crucial moment in the debate over health policies in Morocco. By tackling high medicine costs, the government is opening the way for structural reforms that could integrate biosimilars as a strategic pillar.

Morocco has a unique opportunity to become a regional leader in biosimilars by drawing on successful international models. By investing in local production, improving regulation and carrying out awareness campaigns, the Kingdom can not only guarantee equitable access to care, but also establish its position as a driver of an African health strategy.

How can Morocco effectively mobilize its resources and stakeholders to turn this opportunity into a real regional success?