By Julia Nagy
Recently the Boston University School of Public Health Pharmaceuticals Program presented a symposium called Innovation and Implementation: Bringing New Health Technology to the Developing World. The talk covered a wide variety of topics regarding the economic, infrastructural, and social challenges that stand between what we know should be done, and what we actually do regarding health delivery in low and middle income nations. As a naive, newly minted public health student this seminar was extremely in depth and eye opening. An important aspect of the symposium was a discussion about the difficulties involved in making the best drugs affordable, and thus accessible, to all.
A natural reaction for many involved in public health is to demonize the pharmaceuticals companies as greedy mega-corporations taking advantage of the desperation of ill individuals. However, when one realizes that the average new drug costs over $1 billion to develop, the price of pills becomes a little more reasonable sounding. And when we take into account the money put into failed drugs, depending on the company, it can average out to more than $10 billion per successful drug (Harper). By the time production costs (including materials, labor, and equipment) are accounted for, drug production becomes an almost unsustainably high-cost process, thus the seemingly inflated prices of pharmaceuticals. Luckily, in many countries insurance companies help offset these expenses, but in the poorest countries, which are often most in need, help is harder to come by.
There are a few ways in which the gap between what medical technology is available, and what is affordable, is filled. Frontline, off-patent, generic drugs are available at lower prices for many chronic conditions such as high blood pressure, depression, and diabetes. Additionally, many companies don’t patent materials, such as malaria drugs, which are only needed in the developing world. For HIV medications, there is also a “medicines patent pool”, creating partnerships with generic drug manufacturers in order to lower prices and improve access and availability, especially for the benefit of lower and middle income countries. In some countries, patent laws are much more lax than in Western nations, resulting in increased production of newer drugs. Also, because of cheaper labor and the fact that these manufacturers do not have to worry about being sued for a 1 in 1,000,000 adverse reaction, the drugs can be produced at much lower prices, but retain high quality.
The trouble with making new, effective drugs available to developing nations arises when the high price of development and these circumventions of the patent system collide. If a drug company cannot make money off of their discovery, where is their incentive for innovation? For this reason, charitable foundations must continue to push for progress by continuing to serve as a market for these drugs. Currently, this most often accomplished using advanced purchases. This demand guarantees a market for new medicines, decreasing the risk for drug companies. Another model, which is gaining traction, uses health impact incentives. In addition to a base price, companies are paid depending on how large an impact their health technology makes. This impact can sometimes be difficult to isolate and measure, but building a reporting infrastructure would be beneficial not only for identifying the health impact of medicines, but also for epidemiology in general. Drug companies, and the groups they partner with, must continue to search out new models and techniques (both distributional and production based) to make medicines affordable to all. Only then can we can better the whole world, not just the affluent nations.
1. Harper, Matthew. “The Truly Staggering Cost of Investing New Drugs.” Forbes 12 02
2012, n. pag. Print. <http://www.forbes.com/sites/matthewherper/2012/02/10/the-
2. Innovation and Implementation: Bringing New Health Technologies to the Developing
World. Boston University School of Public Health Pharmaceuticals Program.
Massachusetts, Boston. 22 Feb 2013. Lecture.
3. “What is a Patent Pool?.” Medicines Patent Pool. N.p.. Web. 23 Feb 2013.