[Ip-health] suggestions for a HIF pilot drug
pbond at mail.ngo.za
Sat May 22 21:18:16 PDT 2010
Thanks for this important work, Aidan.
But I'm wondering about its appropriateness, as I've always felt there
are two directions for global public policy on health R&D:
1) creative incentivization strategies that further *commodify* drug R&D
(albeit by performance not effective demand) as along the lines below
(Thomas Pogge has also set out the case in detail);
2) creative public investment in *decommodified* drug R&D, production
and distribution - e.g. NHI for early ARVs, TRIPS exemptions (Doha
2001), and the Global Fund for subsidized supply of generics and
assistance in establishing local production facilities, all prompted by
civil society activists, exemplified by South Africa's Treatment Action
While we have so many public health disasters, it makes sense to try as
many strategies as possible, as each disease needs a different approach.
However, it strikes me that these two foundational approaches above are
fundamentally opposed, at some stage. Is that correct? And if so, isn't
the TAC model preferable, and proven?
Aidan Hollis wrote:
> ****Seeking suggestions for a HIF pilot****
> Incentives for Global Health is working towards a pilot of the reward mechanism for the Health Impact Fund (http://www.healthimpactfund.org). The goals of the pilot are (1) to enable the distribution of a medically valuable drug at a low price in a developing country; and (2) to explore the feasibility of making reward payments depend explicitly on the measured health impact of a drug. We are now seeking suggestions for a suitable drug.
> (1) How would the pilot work?
> The pilot would consist of a contract between a country, a pharmaceutical company, and probably a third-party payer. The contract would require the company to supply a specified product at a specified low price in the country during a specified period. In return, the company would be eligible for a supplementary payment explicitly based on the assessed health impact of the product in the country during the period.
> (2) What products are suitable?
> We are particularly interested in identifying patented products that have a substantial therapeutic potential but are currently underused because of high pricing.
> (3) What countries are suitable?
> We would like to run pilots in a variety of countries at different stages of development and with different health systems.
> (4) What value would such a pilot have?
> First, such a pilot would help to increase access for patients in the country to the pilot product. Second, the pilot would enable a real test of contracting over assessed health impact. The HIF is one of several proposals that delink the reward for innovation from prices, and that make the reward for innovation conditional on assessed health impact. The pilot would offer some practical lessons on how to write contracts in which payments are based on health impact.
> (5) Who will be involved in the pilot?
> This will depend on the pilot, but the actors could involve: (1) The country government, (2) the company, (3) In-country health experts, (4) Incentives for Global Health, (5) A qualifying international health or aid organization granting financial or technical support to the trial, and (6) various technical experts including epidemiologists, health economists, lawyers, etc.
> If you have ideas about what drugs would be most suitable for a test of assessing health impact, please contact me at the address below. I would also welcome other comments or suggestions on the pilot.
> Aidan Hollis
> Professor of Economics
> University of Calgary, 2500 University Dr NW Calgary AB T2N 1N4 Canada
> tel: +1 403 220 5861 fax: +1 403 220 5861
> email: ahollis at ucalgary.ca
> web: http://econ.ucalgary.ca/hollis.htm
> Incentives for Global Health
> Ip-health mailing list
> Ip-health at lists.keionline.org
More information about the Ip-health