[Ip-health] MSF on Managing IP - Time for a rethink: why the R&D system needs to change
joanna.l.keenan at gmail.com
Thu Feb 6 03:00:41 PST 2014
*Time for a rethink: why the R&D system needs to change*
Katy Athersuch - Medical Innovation and Access Advisor, Médecins Sans
Frontières Access Campaign
Two events over the last couple of weeks have shone a spotlight on what is
wrong with the current model of medical innovation. The first was the
reported statement by Bayer CEO Marijn Dekkers that their cancer drug
Nexavar was not developed 'for the Indian market' but for 'Western patients
who can afford this product'.
The second event was the announcement by AstraZeneca that it is closing its
TB, malaria and neglected tropical diseases research and development (R&D)
facility and will no longer be carrying out early stage research in these
areas. This announcement follows Pfizer's exit from the anti-infectives R&D
field altogether last year.
What do we learn from this?
We learn that we need a new model for R&D- one that doesn't deliberately
exclude the poor, uninsured and underinsured from sharing in the benefits
of innovation; won't bankrupt public health care systems; one that will
deliver the much-needed breakthroughs that people in developing countries
are still waiting for.
We face a major challenge, for example, with drug-resistant forms of
tuberculosis - one we are badly equipped to tackle since we don't have the
right tools with which to do so. Multidrug-resistant (MDR) TB treatment is
particularly difficult; it requires two years, including eight months of
daily injections and more than 14,600 pills to swallow, many of which have
toxic side effects such as deafness, psychosis and severe nausea. What is
worse, the success rate is unacceptably low; less than half of patients are
cured, and costs for current treatment can be high, over US$5,000.
Finding an effective treatment regimen for this deadly disease would be
somewhere near the top of a public health priority list; yet where is the
investment? Only 32% of the estimated funding needed for TB drug
development was met in 2012, and 61% of this came from the public and
philanthropic sectors <#_ftn1>. There is some optimism for TB treatment
because, for the first time in 50 years, two new drugs have come to the
market - yet if we look closer, this optimism is misplaced. TB must be
treated with a combination of drugs, but a lack of collaboration and
transparency, due to patent barriers erected by companies, means that
clinical trials to test the new drugs in combinations to ensure they are
safe in new, better regimens will not be completed for several years. How
long will patients be asked to wait? How many will die waiting?
Unless we separate the financing of R&D from the incentive of high prices
we will not be able to fix this broken R&D system. TB patients will
continue to be failed, and cancer patients in developing countries will
continue to be overlooked by pricing structures focused on wealthy
countries - where people are increasingly unable to afford to pay the
$100,000 price tags which are now common. The industry must embrace
alternative incentive mechanisms that will provide the much-needed
breakthroughs in innovation at a price everyone can afford. Burying heads
in the sand while millions of people are excluded from the benefits of
innovation is no longer acceptable.
 <#_ftnref1> P.20,
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
Please sign MSF's DR-TB Manifesto today: www.msfaccess.org/TBManifesto
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