Why the Model for Pharmaceutical Innovation Is Mortally Ill

[This article is written by Elena Villanueva (Policy Coordinator, ISGlobal) and Gonzalo Fanjul (Policy Director, ISGlobal)]

The price of fully vaccinating a child is 70 times higher today than it was in 2001. GSK and Pfizer—the sole producers of the pneumococcal vaccine—have reported over $19 billion in sales of the vaccine globally since its launch. There is something terribly wrong with a system of innovation and access to medicines that allows millions of people to die when the drug that would save their lives could be developed, manufactured and sold at a price that would cover the cost of production—including R/D investment—and yield a reasonable profit.

ISGlobal has decided to publish a series of reports on innovation and access to medicines with a view to disentangling the threads of this complex problem

The Ebola epidemic, the controversy surrounding the cost of treatment for hepatitis C, and the increase in antibacterial resistance have revitalised a debate that has been for far too long confined to expert and activist circles.  Today, patients and taxpayers in dozens of countries—wealthy, emerging and poor—not only wonder whether the drugs they need will be developed, but also where the money to pay for them will be found and why the prices they must pay are exorbitant.

Opinions about the best alternative to this broken model are as numerous as the public, business and civil society stakeholders involved in the debate. There is, however, a growing consensus that a solution to the problem must be found. For the first time in years, we have an opportunity to consider the limitations of the current model of innovation and access to medicines and to propose alternative solutions.

Not all the problems with the current model are related to the patent system or the attitudes of pharmaceutical companies

Not all the problems with the current model are related to the patent system or the attitudes of pharmaceutical companies. To require the exclusion of pharmaceutical companies from the eventual solution to the problem would be just as serious an error as stubbornly maintaining a model that has been commandeered by private interests. We need a fair and effective system of incentives that will assure the important contribution of the private sector to innovation and the distribution of medicines. At the same time, it is essential to safeguard the public interest through legislation designed to prevent abuses of power and by making available the resources needed to ensure innovative research into treatments for less profitable diseases.

It is time to align the model of pharmaceutical innovation with the right to health for all. The first step is to recognise that the status quo is unsustainable and to accurately identify the dilemmas that must be resolved if we are to develop a system that can guarantee patients’ access to essential medicines at affordable prices while recognising the legitimate right of the pharmaceutical companies to make reasonable profits from their business.  This is exactly what is being proposed by It´s Not Healthy, a campaign started in Spain by a group of medical, scientific and social organisations.

There is something terribly wrong with a system that allows people to die when the drug that would save their lives could be developed at a price that would cover the cost of production- including R/D - and yield a reasonable profit

The extreme positions adopted by certain pharmaceutical companies and some activist groups have not only failed to overcome the barriers to access, they have had the opposite effect. This failure is another reason why the Barcelona Institute for Global Health (ISGlobal) has decided to publish a series of reports on innovation and access to medicines with a view to disentangling the threads of this complex problem and stimulating the sort of dialogue that should form the basis of any constructive public debate. Our experience in scientific research and its application and our ongoing collaboration with public, social and business organisations has encouraged us in this endeavour.

It is time to align the model of pharmaceutical innovation with the right to health for all

The first report -Biomedical Innovation and Access to Essential Medicines: Alternatives to a Broken Model- is ISGlobal’s first public position in this field, and its purpose is not to offer prescriptive solutions but to ask the right questions and create the necessary conditions for an informed public debate. This is the first in a series of reports that will come out over the coming months. The next one will exemplify the problem of access to medicines using the case of hepatitis C. This will be followed by two reports that will discuss the cases of antibiotics and treatments for Chagas disease. Each of these examples exemplifies a problem of a different kind, but the effect is similar in each case. The final report in the series will make key proposals for a real reform of the model.

Rather than recommending solutions, our aim in these reports is to further a pragmatic understanding of the problems involved and to encourage a debate focused on the key issues and based on available scientific and economic evidence rather than one argued from the standpoint of ideological prejudices or financial interests.

More information

Report "Biomedical Innovation and Access to Essential Medicines: Alternatives to a Broken Model"

ISGlobal’s work on pharmaceutical innovation and access to medicines