[Ip-health] FT editorial: Drugs win prizes

Thirukumaran Balasubramaniam thiru at keionline.org
Thu Jun 7 01:29:31 PDT 2012


Drugs win prizes

Imagine a world in which companies had economic incentives both to develop valuable new products and to ensure that they were rarely used despite high demand.

That might sound surreal, but it is the magic formula health specialists are seeking to tackle the scourge of antibiotic resistance. “De-linking” financial rewards for new medicines from the need to sell large volumes to recover costs is one promising approach.

Half a century ago, many thought penicillin and other antibiotics would put an end to fatal infections. Yet many tens of thousands of patients around the world each year are dying because these drugs now often fail to kill resistant microbes. The reasons include excessive use in humans and animals; failure of patients to complete their courses of treatment; substandard drugs; and inadequate hospital hygiene and infection control. New medicines are also urgently required. But apart from considerable scientific challenges, pharmaceutical companies have few incentives. Sales are modest, treatment requires just a few pills, and there is little appetite among healthcare systems to pay high prices after decades of reliance on old, cheap generics.

With existing antibiotics far too widely administered – in many countries even without prescriptions – medical specialists are increasingly keen to ration a new generation of antibiotics as tightly as possible to fend off resistance.

One approach to stimulate research is “push” incentives. The European Commission and the pharmaceutical industry made a good start this month, putting up €224m through their Innovative Medicines Initiative partnership to spur collaborative work between academics, doctors and companies.

Industry also needs “pull” incentives to guarantee that if a company successfully completes costly clinical trials for a new drug, it will be rewarded. It proposes a form of “advance purchase commitment”, stockpiling or prize of pooled funding from different governments, large enough to eliminate the need for aggressive marketing to maximise sales.

That sits ill with reluctance by countries to collaborate on health policy. It also raises questions about how to value a new antibiotic’s medical benefit, and on what terms to offer it to countries that did not contribute but have patients in need. Manufacturers will have to be prevented from rapidly producing and selling unauthorised copies. The task will not be easy, but without fresh efforts, drug resistance will only grow.


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)

thiru at keionline.org

Tel: +41 22 791 6727
Mobile: +41 76 508 0997

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