[Ip-health] Senator Sanders: Making AIDS treatment affordable for all sufferers
james.love at keionline.org
Thu Dec 1 10:03:37 PST 2011
This is a op-ed by Senator Bernie Sanders, talking about S. 1138, the Prize
Fund for HIV/AIDS
Making AIDS treatment affordable for all sufferers
By Sen. Bernie Sanders (I-Vt.) - 11/30/11 07:04 PM ET
When World AIDS Day was first observed in 1988, there was no truly
effective treatment for what was almost always a deadly disease. Today the
biggest problem in caring for those with AIDS is no longer mainly a medical
or scientific problem — the crisis is access to affordable drugs.
Despite medical breakthroughs, AIDS drugs cost way too much for way too
many to afford. Fortunately, there is a promising solution. We must break
the link between rewards for research and the prices charged for new drugs.
Despite tremendous scientific advances, AIDS has not gone away. The U.S.
Centers for Disease Control and Prevention estimates that there are more
than 1.1 million people living with HIV/AIDS in the United States, and that
56,000 people are newly infected every year. Globally, the numbers are more
staggering. The World Health Organization says more than 33 million people
are living with HIV/AIDS, and 2.5 million are infected each year. Ninety
percent of HIV positive people live in developing countries — some 29
million people. Only 6 million of those receive the most effective
treatment for AIDS, the antiretroviral drugs known as ARVs.
Matters are likely to get worse. The United States is backing off its
commitment to the successful Global Fund to Fight AIDS, Tuberculosis and
Malaria, and other countries are following suit. Just last week, the Global
Fund announced that it will not be able to reach more people suffering from
these devastating diseases until 2014.
The problem with access to affordable care is not only a third-world
concern, it’s a problem right here at home. A three-drug regime like
ATRIPLA costs less than $200 to make but sells for $24,000 per patient per
year in the U.S. Some newer combination therapies are even more expensive.
Funding shortfalls for federal- and state-subsidized AIDS drug-assistance
programs, however, have caused waiting lists to grow. A list that was
whittled down to 361 people a year ago grew to 6,595 people in 12 states as
of last month. Many more are simply being thrown off the waiting lists due
to stiffer eligibility requirements.
The big winners under the current system have been the pharmaceutical
companies. The lucrative incentive for drugmakers to invest in research and
development is a 20-year monopoly on a profitable new invention. Many
people thought this approach was necessary to stimulate R&D. It’s not.
There is a better way. Many economists, in fact, are now questioning the
costs and benefits of old-fashioned pharmaceutical monopolies and look to a
new model as a way to reward innovation and make affordable medicine
available to millions more people.
I introduced a bill in the Senate that would test this new approach on
drugs developed to treat one disease: HIV/AIDS. The measure (S. 1138) would
eliminate legal barriers to generic competition for HIV/AIDS drugs and
reward innovation directly, through a $3 billion a year prize fund. It
would unleash unprecedented advances in medical innovation in decades to
come by also requiring that at least 5 percent of the prize money go to any
individual, business or nonprofit organization that openly shared
information, data, materials or technology that contributed in a positive
way to the development of new drugs.
The prize fund approach recognizes that we need to foster and reward
medical innovations, but separates the market for innovation from the
market for the drugs themselves. This approach has many benefits —
dramatically lower prices being the most obvious. Experts estimate that the
$10 billion U.S. market for AIDS drugs can be supplied at generic prices
for anywhere from $500 million to $1.5 billion. So, even after spending $3
billion per year on the prize fund, there will be a huge overall savings.
Saving money isn’t the only reason this is a good idea. The prize fund also
will stimulate innovation. It will give larger rewards for drugs that
improve healthcare outcomes and smaller or no rewards for duplicative,
“me-too” drugs that are medically insignificant. It also would eliminate
incentives to engage in wasteful marketing activities. Prize fund rewards
will be based on evidence that drugs actually work and work better than
The prizes would be funded by the federal government and private health
insurers in an amount proportionate to their share of the HIV/AIDs drug
market. Insurance companies and self-insured employers should welcome the
new model. The cost of the prize fund would be considerably less than the
cost of buying drugs at monopoly prices.
>From the beginning, the HIV/AIDS pandemic has presented very difficult
challenges. The current challenge is to make access to treatment
sustainable for more than a million people in the U.S. and tens of millions
in developing countries. The prize fund model reconciles innovation and
access. If the U.S. can transform its domestic market for HIV/AIDS drugs,
it will certainly transform the world market, and make HIV/AIDS drugs more
affordable for everyone, everywhere.
Sanders is a member of the Senate Health, Education, Labor and Pensions
James Love. Knowledge Ecology International
http://www.keionline.org, +1.202.332.2670, US Mobile: +1.202.361.3040,
Geneva Mobile: +41.76.413.6584, efax: +1.888.245.3140. Sometimes I am
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