[Ip-health] HIF submission to the WHO's CEWG

Ting Ting Cheng tingting.cheng at healthimpactfund.org
Tue Jun 21 06:30:25 PDT 2011

Incentives for Global Health has made a submission to the WHO’s CEWG on the
Health Impact Fund. The submission is available at


The summary page, without formatting, is copied below.

Proposal Name:  Health Impact Fund

Submitted by: Incentives for Global Health

Description of the proposal

The proposed Health Impact Fund (HIF) is a novel mechanism designed to
stimulate development of, and to ensure real access to, new medicines. The
HIF would offer innovators the option to register new drugs, vaccines, and
even new uses for older drugs. Registration would commit the innovator to
supply the drug globally at cost and entitle it to ten years of reward
payments. The annual reward for each drug would be a share of the total
rewards available, equal to the share of health impact achieved by that drug
as a proportion of health impact achieved by all registered products. The
HIF is to be financed by willing governments according to national income.
The cost to governments and taxpayers would be largely offset by lower
prices on drug purchases and insurance premiums.

Crucially, the HIF makes rewards dependent on assessed health impact, as
measured with a metric such as quality-adjusted life-years (QALYs). The
reward for any product would depend each year on the measured health impact
of that product and of all other registered products. The measurement of
health impact would not be perfectly precise, and therefore must be
insulated from stakeholder interests that could bias results. As long as a
methodology can be applied consistently, it will be useful for
across-country and across-product comparisons. Irrespective of the
limitations of health impact assessment, it is clear is that tying financial
return to a measurement of value (such as QALY) would equalize the incentive
to deliver treatment to all persons, regardless of income. This would
constitute a significant advance from the status quo in enabling broader
access to important new treatments.

The HIF compactly integrates all the processes from innovation to delivery:
firms are rewarded not for innovation as such, but only for measurable end
results. They are thus given efficient incentives to anticipate and address
all obstacles to the optimal deployment of their products.

Optional registration in the HIF ensures that the reward rate per unit of
health impact is reasonable. If rewards became too rich, additional products
would be registered, driving down rewards per QALY; if rewards were too low,
the reverse would occur. Such self-adjustment reassures taxpayers that they
are not funding windfalls for pharmaceutical innovators while assuring
innovators of a decent return on their investments.

The HIF will be especially attractive for drugs that have high therapeutic
potential but low expected commercial value outside the HIF. This includes
new drugs for “neglected” diseases as well as innovations with weak or no
patent protection. The HIF would nonetheless be open to any health-improving
pharmaceutical, regardless of the disease.

Comments, questions etc are always welcome at contact at healthimpactfund.org.

Ting Ting Cheng,

Senior Project Manager

Incentives for Global Health


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