Global Pharmaceutical R&D - Some Political Economy & Public Policy Considerations

GLOBAL PHARMACEUTICAL R&DSome Political-Economy & Public Policy Considerations

CHIRANTAN CHATTERJEEIIM-Bangalore

Sept 1 2014

International Infectious Diseases & Global Health Training Program Karnataka Health Promotion Trust

Sources for data & figures: World Wide Web (unless otherwise mentioned)

Do you believe that New Medicines are Good for Society?

Source: Lichtenberg 2005

New Medicines Seem to be Good for Society

Source: Lichtenberg 2005

But New Medicines are costly raising Affordability Issues: Case of Antiretrovirals

Source: http://apps.who.int/medicinedocs/documents/s18716en/s18716en.pdf

How can you balance Access versus Innovation in Pharmaceutical R&D?

- Solutions?- No Easy Answers- Innovator Firms Focus on R&D spending in

therapeutic markets (usually in rich-world diseases) that give them returns on R&D with their monopoly rents protected through patents.

- But when poor needs those drugs like in HIV or Cancer, patents are often side-stepped, causing tussles between innovators & imitators, developed and developing countries.

- But if patents are disrespected, no innovation might happen

A Classic Egg-Chicken-Egg Public Policy Problem

Boiling into Policy Disputes between Countries

What Might be a Solution? Some Policy Levers

1) Stronger Patents in Developing & Least Developed Countries?

2) Compulsory Licenses?3) Differential Pricing?4) Advanced Market Commitments as in case of

Vaccines?5) Priority Review Vouchers?6) Health Impact Fund?7) ALS Ice-Bucket Challenge?8) Any thing else?

TRIPS & Global Public Health

Compulsory Licensing

Differential Pricing

Source: Chatterjee, Kubo, Pingali 2014

Differential Pricing

Source: Chatterjee, Kubo, Pingali 2014

Advanced Market Commitments

Priority Review Voucher (Ridley et.al)Drugs for Neglected Diseases

https://www.youtube.com/watch?v=LSlF4hT8TYg

Health Impact FundThomas Pogge – Yale University

https://www.youtube.com/watch?v=7HLLq-FY57I

ALS Ice-Bucket Challenge A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?

ALS Ice-Bucket Challenge A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?

Source: http://www.vox.com/2014/8/20/6040435/als-ice-bucket-challenge-and-why-we-give-to-charity-donate

Some Other Considerations Here Universal Health Coverage & Government Funded

National Health Insurance Schemes?

Price Control of Drugs?

The role of Low-End Disruptors?

State Procurement Agencies like TNSMC/Locost (Public or Private)?

Quality of Medicines/Counterfeit/Banned Medicines?

Role of Alternative Medicines (the search for Sanjeevani)

Biologics & Bio-similars?

Anything else?

So No Answers from me – Still Mulling!

- But maybe one needs to think about:

A Tiered Therapeutic Market Approach.

Contemplate the role of Innovation Prizes (like PRV, HIF)

A Straight-Up Patents/No-Patents World might not be a solution

Giants on Whom we Stand (and there are many)

Joseph Stiglitz, Boldrin & Levin Jenny Lanjouw (ex-UC Berkeley), F. M. Scherer (Kennedy-Harvard), Iain

Cockburn (Boston-U), Henry Grabowski & Frank Sloan (Duke-U), Richard Manning (Bates & White)

Pinelopi Goldberg (Yale), Anita McGahan (Rotman-Toronto), Margaret Kyle (Toulouse U.), Yi Qian (UBC-Northwestern), Panle Jia (Cornell), Antara Dutta (Bates & White)

Dana Goldman, Tom Philipson, Darius Lakdawalla, Neeraj Sood (USC/Precision Health Economics)

Ashish Arora (Duke), Lee Branstetter (Carnegie-Mellon), Matt Higgins (Georgia Tech), Mariko Sakakibara (UCLA)

Sudip Chaudhuri (IIM-Calcutta) and Shubham Chaudhuri (World Bank) And some others who are on this journey to unravel this puzzle like

me.

Thank You for your time

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