global pharmaceutical r&d - some political economy & public policy considerations
TRANSCRIPT
GLOBAL PHARMACEUTICAL R&DSome Political-Economy & Public Policy Considerations
CHIRANTAN CHATTERJEEIIM-Bangalore
Sept 1 2014
International Infectious Diseases & Global Health Training Program Karnataka Health Promotion Trust
Sources for data & figures: World Wide Web (unless otherwise mentioned)
Do you believe that New Medicines are Good for Society?
Source: Lichtenberg 2005
New Medicines Seem to be Good for Society
Source: Lichtenberg 2005
But New Medicines are costly raising Affordability Issues: Case of Antiretrovirals
Source: http://apps.who.int/medicinedocs/documents/s18716en/s18716en.pdf
How can you balance Access versus Innovation in Pharmaceutical R&D?
- Solutions?- No Easy Answers- Innovator Firms Focus on R&D spending in
therapeutic markets (usually in rich-world diseases) that give them returns on R&D with their monopoly rents protected through patents.
- But when poor needs those drugs like in HIV or Cancer, patents are often side-stepped, causing tussles between innovators & imitators, developed and developing countries.
- But if patents are disrespected, no innovation might happen
A Classic Egg-Chicken-Egg Public Policy Problem
Boiling into Policy Disputes between Countries
What Might be a Solution? Some Policy Levers
1) Stronger Patents in Developing & Least Developed Countries?
2) Compulsory Licenses?3) Differential Pricing?4) Advanced Market Commitments as in case of
Vaccines?5) Priority Review Vouchers?6) Health Impact Fund?7) ALS Ice-Bucket Challenge?8) Any thing else?
TRIPS & Global Public Health
Compulsory Licensing
Differential Pricing
Source: Chatterjee, Kubo, Pingali 2014
Differential Pricing
Source: Chatterjee, Kubo, Pingali 2014
Advanced Market Commitments
Priority Review Voucher (Ridley et.al)Drugs for Neglected Diseases
https://www.youtube.com/watch?v=LSlF4hT8TYg
Health Impact FundThomas Pogge – Yale University
https://www.youtube.com/watch?v=7HLLq-FY57I
ALS Ice-Bucket Challenge A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?
ALS Ice-Bucket Challenge A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?
Source: http://www.vox.com/2014/8/20/6040435/als-ice-bucket-challenge-and-why-we-give-to-charity-donate
Some Other Considerations Here Universal Health Coverage & Government Funded
National Health Insurance Schemes?
Price Control of Drugs?
The role of Low-End Disruptors?
State Procurement Agencies like TNSMC/Locost (Public or Private)?
Quality of Medicines/Counterfeit/Banned Medicines?
Role of Alternative Medicines (the search for Sanjeevani)
Biologics & Bio-similars?
Anything else?
So No Answers from me – Still Mulling!
- But maybe one needs to think about:
A Tiered Therapeutic Market Approach.
Contemplate the role of Innovation Prizes (like PRV, HIF)
A Straight-Up Patents/No-Patents World might not be a solution
Giants on Whom we Stand (and there are many)
Joseph Stiglitz, Boldrin & Levin Jenny Lanjouw (ex-UC Berkeley), F. M. Scherer (Kennedy-Harvard), Iain
Cockburn (Boston-U), Henry Grabowski & Frank Sloan (Duke-U), Richard Manning (Bates & White)
Pinelopi Goldberg (Yale), Anita McGahan (Rotman-Toronto), Margaret Kyle (Toulouse U.), Yi Qian (UBC-Northwestern), Panle Jia (Cornell), Antara Dutta (Bates & White)
Dana Goldman, Tom Philipson, Darius Lakdawalla, Neeraj Sood (USC/Precision Health Economics)
Ashish Arora (Duke), Lee Branstetter (Carnegie-Mellon), Matt Higgins (Georgia Tech), Mariko Sakakibara (UCLA)
Sudip Chaudhuri (IIM-Calcutta) and Shubham Chaudhuri (World Bank) And some others who are on this journey to unravel this puzzle like
me.
Thank You for your time