[Ip-health] Guardian editorial: The Guardian view on new drugs: high hopes, higher prices

Thiru Balasubramaniam thiru at keionline.org
Mon Feb 4 01:04:15 PST 2019

https://act. .org/planb/ <https://act.justtreatment.org/planb/>



The Guardian view on new drugs: high hopes, higher prices

The row over the cost of a cystic fibrosis treatment has prevented its use
in the UK. These patients, many of them children, deserve better

Sun 3 Feb 2019 18.45 GMTLast modified on Sun 3 Feb 2019 18.55 GMT

 ‘New drugs emerge not according to need, but when companies know they can
make sizable profits from them.’ Photograph: REB Images/Getty Images/Blend

Medical advances come at a cost, and that cost is increasingly steep. We
rely on pharmaceutical companies, as well as public and philanthropic
investment, to develop the medicines that can transform and even save
lives. New drugs emerge not according to need, but when companies know they
can make sizable profits from them. The problem with this, beyond our
intuitive sense of wrongness when people reap lavish rewards thanks to
products others cannot live without, is twofold. Some diseases or
conditions – particularly those prevalent in poorer countries – are
ignored, while treatment for other health problems may come at a heavy

Governments and patients around the world are struggling to cope with
escalating costs. Last year a report suggested that the average annual
price of new cancer drugs had almost doubled in the US between 2013 and
2017 – and would double again by 2022. Companies blame the cost of
development and say they need to recoup their investment before rivals are
able to pile in with generic competitors. They are less keen to acknowledge
their often sky-high profits, the fact that some put more into share
buy-backs than research and development, and the reality that many new
offerings are “me-too”variations rather than game-changing innovations.
Patients and shareholders are likely to draw the line that distinguishes a
fair reward from greedy profiteering in very different places.

The problem is especially acute for drugs that do not have a large market –
either because the aim is to use them only as a last resort to preserve
their efficacy; or because the disease or condition is an uncommon one.
Last month, the health secretary, Matt Hancock, proposed incentivising
pharmaceutical companies to develop new drugs to tackle anti-microbial
resistance by paying for the medicines according to their value to the
health service, rather than by the quantity used. It is a welcome step,
though international cooperation will be needed if it is to have real

Now Mr Hancock is being asked to show boldness in another case. A US
manufacturer has set the price of a drug called Orkambi, which could extend
the lives of thousands of children with cystic fibrosis, at more than
£100,000 a year. Britain is home to more than a tenth of the 100,000 people
worldwide affected by the life-limiting genetic disorder. But the NHS
cannot afford Orkambi: the National Institute for Health and Care
Excellence (Nice) says it is simply so expensive that it is not cost
effective. Other companies have budged in similar circumstances; but the
drug’s maker, Vertex, refuses to do so. It rejected an offer of £500m over
five years for access to its cystic fibrosis drugs as inadequate and
unfair; it is understood to have spent $3.3bn on the patents for the drug,
though campaigners say it has already earned $2.5bn from sales. The head of
specialised commissioning for NHS England has described the company as “an
extreme outlier in terms of both its pricing and behaviour”.

As the Guardian reveals today, parents and the medicines group Just
Treatment are urging the government to invoke “crown use”, allowing it to
make cheap versions and pay Vertex a smaller sum in compensation. This
would be very unusual, but not unprecedented. The principle that
intellectual property rules cannot automatically outweigh health
considerations is well established, and not only in public opinion; it is
recognised in the WTO’s Doha declaration of 2001. Mr Hancock should heed
the campaigners’ call. The hopes raised by this powerful drug should not be
dashed. If crown use sent a broader message on acceptable pricing, all the

Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International
41 22 791 6727
thiru at keionline.org

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