Tokyo, Monday, 3rd June 2019
Dear Prime Minister Abe,
We are the Biopharmaceutical CEO Roundtable members representing global R&Dbased pharmaceutical company. We have committed to deliver innovative medicines/medical
technologies all over the world including Japan, to build a vibrant society that enables people
live longer, healthier, and happier without suffering from disease through access to new
medicines. We appreciate your leadership in designating the biopharmaceutical industry a key
strategic industry for Japan. For the coming G20 meetings in Japan, as a country committed toadvancing medical innovation, we welcome Japan’s solid leadership globally, but also in thefollowing three global health issues for the realization of our ultimate goal.
The first aspect is we still do not have enough engagement for health systems
strengthening to reach the goal of universal health coverage (UHC) – ensuring access toappropriate healthcare services with reasonable cost – especially, in developing countries. We
commend the Government of Japan’s continued support for the Global Fund and the Gavi
Alliance, and its leadership in hosting the Gavi replenishment launch event in August. So far,GOJ, as part of its global leadership on healthy aging, has greatly supported moving towards
UHC, together with the international community, and raised the health agenda as a prioritized
topic at the international fora (e.g., United Nations, G7 Summit, or TICAD). In particular, theGOJ reaffirmed the following needs at the UHC Forum 2017 in Tokyo: 1) to strengthen global
momentum towards UHC, 2) to develop and implement a framework for cooperation at thecountry level, 3) to monitor progress continuously, 4) to secure sustainable financial resources
for UHC, and 5) to promote innovation. Furthermore, G7 Ise-Shima vision reaffirms theimportance of immunization, throughout the life course, as one of key measures to prevent thespread of infectious disease and address emerging pandemics. We, the pharmaceuticalcompanies, would like to support PM Abe’s strong leadership in these areas. Also, we havebeen proactively engaged to establish our contribution toward health systems strengthening
through our own Initiative (Access Accelerated*) to bring all relevant stakeholders together.
Recognizing that substantial hurdles remain, we need to encourage individual countries tofurther implement or strengthen actions to promote UHC. To this end, we look forward to yourcontinuous support to mobilize country-led processes towards UHC, increase alignment ofindividual efforts, and accelerate UHC goals globally.

International
Federation of
Pharmaceutical
Manufacturers &Associations

Ch. Des Mines 9
P.O. Box 195
1211 Geneva 20
Switzerland

Tel: +41 22 338 32 00
Fax: +41 22 338 32 99
www.ifpma.org

The second aspect is although many medical products have become available to datefor certain diseases, there are still either no treatments for, or ineffective or inadequatetreatments for many other diseases. This is a common issue for both developed and developing
countries. We, the R&D based pharmaceutical companies, underscore the value of partnershipand believe that partnerships are a fundamental component for fostering innovation. The AMR(Anti-microbial Resistance) Industry Alliance initiative**, our multi-stakeholder coordination
platform that addresses a global public health concern of antibacterial drug resistance, is justan example.
To facilitate innovation, governmental understanding and support are crucial. We are
grateful for your commitment to support innovation as one of the five commitments
mentioned above. In order to implement the commitment and deliver innovative medicines topatients, we are making all-out efforts to develop innovative medicines. It is vital to instituteharmonized regulatory systems as well as an enforceable reward system for innovativetechnology in each country, in particular the predictable and reasonable protection ofintellectual property (IP) rights. Although some view the IP system as a barrier to access tomedicines, the weight of evidence demonstrates that focusing on areas like pricing and IP inisolation will not achieve long-term successful health outcomes or better access to new
medicines, and must be linked to the core healthcare system issues.
The third aspect is the need to make the shift to a new healthcare system utilizing
various kinds of medical data, especially, taking into consideration the recent advancements ofdigital technologies like AI or big data, and to develop legal frameworks that facilitate theseadvancements, including with respect to data flows. We think the shifts also advance theaforementioned two challenges: 1) accelerating progress towards UHC, and 2) resolving unmet
medical needs. Japan established a national health insurance (NHI) system a long time ago, andthe large amount of health and medical data collected under the NHI system has the potential
to enable the achievement of UHC in response to the aging society through the seamlesscoordination of preventive measures, early diagnosis and treatment, effective use of precision
medicines, and efficient use and optimization of healthcare expenditures. Furthermore, theshift to a new system would enhance utilization of real world data for innovative drug andtechnology development, thereby enabling the R&D pharmaceutical industry to discover anddevelop innovative medicines more quickly and efficiently. For example, use of a public
medical information database or combination of IoT technology and virtual clinical trial canpotentially reduce drug development time and costs and improve the probability of success. As
a result, our innovative products can be delivered earlier to patients in need.

In conclusion, we continue our efforts to join with others to accelerate progress
towards UHC, to resolve unmet medical needs, and to transform to a new healthcare systemutilizing various medical data, so that we can contribute to people’s health globally. We lookforward to Japan’s leadership to guide constructive and evidence-based discussions on these
global topics and shape a strategic policy decision in the G20 and beyond. We look forward tocontinuing to work with you to advance our goals.
Yours sincerely,David A. Ricks
Chairman and Chief Executive Officer
Lilly and Company
President, IFPMA

George Nakayama
Chairman and Chief Executive Officer
Daiichi Sankyo Co. Ltd.

Jean-Christophe Tellier
Chief Executive Officer andChairman of the ExecutiveCommittee, UCB S.A.

Dr. Olivier Brandicourt
Chief Executive OfficerSanofi

Thomas Cueni
Director General, IFPMA* Access Accelerated: Access Accelerated brings together over 20 biopharmaceutical companies committed totackling the growing burden of non-communicable diseases in low and middle-income countries. By collaboratingwith partners, we co-create scalable and sustainable solutions to improve people’s health.
** AMR Industry Alliance: The AMR Industry Alliance is one of the largest private sector coalitions set up to provide
sustainable solutions to curb antimicrobial resistance, with over 100 biotech, diagnostics, generics and researchbased pharmaceutical companies and associations joining forces.

Kenji Yasukawa
Chief Executive Officer
Astellas Pharma Inc

Robert A. Bradway
Chairman and Chief
Executive Officer
Amgen Inc

Michel Vounatsos
Chief Executive Office
Biogen Inc.

Hubertus von Baumbach
Chairman of the Board ofManaging Directors
Boehringer Ingelheim

Werner Baumann
Chairman of the Board ofManagement and Chief
Executive Officer
Bayer AG

Giovanni Caforio
Chairman and Chief
Executive Officer
Bristol-Myers Squibb

Tatsuro Kosaka
President andChief Executive Officer
Chugai PharmaceuticalCo., LtdHaruo Naito, KBE
Representative Corporate
Officer and CEO
Eisai Co., LtdDr. Severin Schwan
Chief Executive Officer
F. Hoffmann-La Roche AG.

Albert Bourla
Chief Executive Officer
Pfizer Inc.

Olivier Laureau
President
Servier Group

Hiroshi Nomura
President and Chief
Executive Officer,
Sumitomo Dainippon
Pharma Co.,Ltd

Danial O’Day
Chief Executive Officer
Gilead Sciences Inc.

Christophe Weber
President and Chief
Executive Officer
Takeda Pharmaceutical Co.
Ltd.

Mark J. Alles
Chairman,
Chief Executive Officer
Celgene Corporation

Kenneth C. Frazier
Chairman, President andChief Executive Officer
Merck & Co., Inc.

Dr. Isao Teshirogi
President and Chief
Executive Officer
Shionogi & Co., Ltd

Dr. Eric Cornut
ChairmanMenarini Industrie
Farmaceutiche Riunite

Dr. Jorge Gallardo
President
AlmirallDebora Dunsire
Chief Executive Officer
H. Lundbeck A/S

Vas Narasimhan
Chief Executive Officer
Novartis AFKåre Schultz
President and Chief
Executive Officer
TEVA Pharmaceutical Ltd.

Pascal Soriot
Chief Executive Officer
AstraZeneca UK Limited

Joaquin Duato
Vice Chairman of the Executive
Committee
Johnson & Johnson

Lars Fruergaard Jørgensen
President and Chief Executive
Officer
Novo Nordisk A/SEmma Walmsley

Chief Executive Officer
GlaxoSmithKline, UKDr. Stefan Oschmann
Chairman of Executive Board
and Chief Executive Officer
Merck KGaADavid Meek
Chief Executive Officer
IPSEN, Pharmaceutical