Providing sustainable and affordable access to heat-stable carbetocin for the prevention of post-partum haemorrhage in LMICs
Commitment description:Millions of poor underserved women risk their lives giving life. Excessive bleeding after childbirth (PPH) is the leading direct cause of preventable maternal death, causing est. 70,000 deaths per year , 99% in low- and lower-middle income countries. For the prevention of PPH, the World Health Organization (WHO) recommends for all births the use of an effective uterotonic during the third stage of labour for the stimulation of uterine contraction. Oxytocin is the first-choice drug for preventing PPH, and has to be stored and transported at 2–8°C to maintain its full effectiveness. In June 2018, the landmark CHAMPION (Carbetocin HAeMorrhage PreventION) trial study was published in the New England Journal of Medicine. It included nearly 30,000 women in 10 countries, and was led by the WHO under a collaborative arrangement between WHO, Ferring Pharmaceuticals and MSD for Mothers. It demonstrated that a new heat-stable formulation of Ferring’s carbetocin was noninferior to oxytocin for the prevention of blood loss of at least 500 ml or the use of additional uterotonic agents, after vaginal birth. Heat-stable carbetocin does not require refrigeration and retains its efficacy for at least three years stored at 30°C and 75% relative humidity . For the thousands of women giving birth in places where refrigeration of oxytocin is lacking or cannot be fully relied upon, this innovation could be lifesaving. Heat-stable carbetocin has been added to the WHO Essential Medicines List of uterotonics for the prevention of PPH, and guidelines have been updated recommending heat-stable carbetocin for PPH prevention in settings where oxytocin is unavailable or its quality cannot be guaranteed, and where its cost is comparable to other effective uterotonics. Once approved, Ferring commits to making heat-stable carbetocin available at a sustainable and affordable price in public sector healthcare facilities in low- and lower-middle income countries (World Bank 2019).
Mode of engagement:
- Programmatic actionOnce approved, Ferring will provide sustainable and affordable access to heat-stable carbetocin for the prevention of post-partum haemorrhage in LMICs in public sector healthcare facilities.
Achieve universal access to sexual and reproductive health as a part of universal health coverage (UHC)(3) Zero preventable maternal deaths and maternal morbidities, such as obstetric fistulas, by, inter alia, integrating a comprehensive package of sexual and reproductive health interventions, including access to safe abortion to the full extent of the law, measures for preventing and avoiding unsafe abortions, and for the provision of post-abortion care, into national UHC strategies, policies and programmes, and to protect and ensure all individuals’ right to bodily integrity, autonomy and reproductive rights, and to provide access to essential services in support of these rights.
