A very interesting public lecture will take place on Thursday, November 5th, 2015 in the UDC Smurfit School. Organised by Jan Rosier, Professor of the Business of Biotechnology at the School Of Biomolecular and Biomedical Science at the UCD Conway Institute, this year's Laurence Crowley Lecture will cover the often controversial topic of how to making highly effective biotechnology drugs affordable.
"I have invited two speakers with very different perspectives on the subject", says Rosier. "One is Professor Thomas Pogge, Leitner Professor of Philosophy and International Affairs at Yale University and Chairman of the Health Impact Fund and the other is Professor Tom Donaldson who is Mark O Winkelman Professor at the Wharton School of the University of Pennsylvania and a noted writer on business ethics. Professor Pogge is a philosopher and looks at the issue from that point of view while Donaldson takes a business perspective."
The motivation behind the lecture is the rapid increase in the cost of medicines over recent years. “Over the past two to five years the price of drugs has increased tremendously,” says Rosier. “Some drugs have gone up in price by between 10 per cent and 50 per cent while others have increased by between 1,000 per cent and 5,000 per cent. This creates a huge problem for society and for governments.”
Pogge has already come up with a proposed solution to the issue in the form of the Health Impact Fund (HIF) (healthimpactfund.org). This offers an alternative way of paying for pharmaceutical innovation by incentivising the development and delivery of new medicines by paying the pharmaceutical companies for the efficacy of the drugs.
Funding
Pharmaceutical firms which register new medicines with the HIF would agree to provide their drugs at the cost of production to patients around the world. Instead of receiving profits from the actual sale of the drug they would be rewarded by the HIF in accordance with the global health impact of the medicine. The HIF would be funded by governments and other donors including philanthropic organisations.
“There should be a system which is not just based on price but where a company is rewarded for the impact its research has made on health and society”, says Rosier. “Patients would only pay the production costs of the drugs and the additional part would be paid by governments or other international organisations.”
While this may sound utopian, the idea has attracted the support of bodies such as the World Health Organisation and independent US senator Bernie Sanders. But it would require a complete change in mindset and business model for the pharmaceutical companies who at present are geared towards driving increased profits in order to reward shareholders.
"At present most pharmaceutical companies are not interested in developing world markets such as India or Zimbabwe, " Rosier explains. "Take a medicine like the pancreatitis drug Glybera, for example. At present a single injection costs $1 million. That is never going to be available in the developing world. It will probably be available in some wealthy Western countries but not very many patients will get it. We have to find solutions to situations like that where patients and health systems simply cannot afford drugs."
Development costs
Part of the problem is the very expensive processes involved in the development of new drugs. It can take up to 12 years and hundreds of millions of dollars to bring a drug from the lab to the market. And for every one that makes it through, hundreds fall by the wayside at some point along the exacting journey. It is little wonder the pharmaceutical companies seek to extract the maximum profit from successful drugs wherever and whenever they can.
But many people, including Hillary Clinton and President Obama, have said that the profit levels have become excessive. "They are saying that if the current trend continues it will break the system", says Rosier. "A solution has to be found."
That is where Prof Donaldson comes in. “For many years people have been asking why they are working for a particular company. He has a different way of thinking. He asks why firms are in the specific business they are in. In the case of the pharmaceutical industry, are they there to create value for shareholders or to deliver health benefits to patients? The pharmaceutical industry is dealing with products that have a fundamental health benefit but their price is not related to their cost. The companies do not only have a responsibility to their shareholders, they have a responsibility to patients as well and we need to find an alternative way to reward biotechnology firms in a very effective way.”
Rosier recognises that this will be easier said than done. “Any alternative system will have to reward the development of new innovative drugs at least as well as the current system does, otherwise we will not get the new drugs. We are not there yet and it will require some deep philosophical thought. But with lectures like this one at least we can start that thought process and prompt a debate about it.”
