“Trilateral” Symposium Addresses Topics Of Global Public Health And IP

The themes of innovation, collaboration, and policy coherence shared the spotlight during panel discussions at the 5 July technical symposium entitled, Medical Innovation: Changing Business Models. The event was jointly hosted by the World Health Organization, World Intellectual Property Organization, and World Trade Organization, and included private sector representatives.

The landscape of health, in general, is changing. Shifting trends in economic development, disease prevalence, and intellectual property protection have all contributed to an increase in cross-sector dialogue. This is the result of an attempt to address the challenge of equitable, efficient, and sustainable medical innovation.

Antimicrobial resistance is an area in which there is huge immediate concern because, as many speakers pointed out, treatments that exist today will be ineffective in the future. The potential of entering a ‘pre-antibiotic era’ has amplified the need for more innovation not only in R&D but also in treatment and quality of care.

Innovation, in its broadest sense, concerns more than purely medical innovation. Richard Laing, medical officer in the WHO Department of Essential Medicines and Health Products, spoke about innovation in health systems as a whole. Laing stressed the need to look for opportunities for innovation in pricing policies, partnerships, and regulatory schemes in order to improve the current status of medical research and development (R&D).

Developing medicines for noncommunicable diseases (NCDs), such as treatments for cancer, will require innovation around pricing structures and policies. Given the epidemiological shift in the burden of disease across the globe, but especially in middle-income countries, the price of medicines will be increasingly disputed, as more people require more expensive, longer-term therapies. Whether drug prices should prioritise the value of medicines or rather cost containment of health care expenditure remains unclear to both governments and industry.

Andrew Jenner, director of innovation and trade policy at the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), suggested that the real question regarding medicine pricing is determining medicines’ true value. He admitted that industry has found this difficult to describe and said that, “value-based pricing looks and feels a lot like cost-containment.”

Jenner said that the difficulty in developed countries is with the limited budget for healthcare that essentially serves as a price cap, and that value-based pricing is therefore “not really the modus operandi if you have a cap.” Jenner recommended that developed countries “work together to find a methodology that can describe the value of a medicine.” He added that a different approach is needed for developing countries because “their ability to pay is different.” Jenner underscored the need think creatively about price structures, and for “an equitable balance between rights and obligations of governments to look after their citizens, and what industry need to do.”

Further industry insight was provided by Petra Laux, head of global public and governmental affairs at Novartis. She said intellectual property is “a way to deal with knowledge and make it available to others.” Laux posed a question, in the context of markets driving innovation, of the extent to which emerging markets will contribute to the payback for R&D.

Richard Wilder, associate general counsel at the Bill & Melinda Gates Foundation, focussed on the importance of data and measurement in informing policy and decision-making. He said that the better quality and availability of data now provides an opportunity to “say something much more specific about burden of disease, what the gaps are, what kind of funding is available.” Wilder added that cooperation among three agencies (WHO, WIPO, and WTO) can largely be facilitated through a “rigorous view of data” in the identification of common goals and how to achieve them.

Collaboration across sectors between partners and stakeholders was regularly mentioned in the presentations made throughout the day. Jenner described a greater desire among companies to share risks, resources, but also to share the rewards. “The new model we are seeing is moving away from profit alone models to profit together models,” he said.

Jenner also provided examples of cross-sector collaboration, such as that of the US government providing funding to Glaxo-Smith Kline to develop treatments for antimicrobial resistance. He summarised his message by quoting an African proverb: “if we go at it alone we go fast, but if we go together we go far.”

The trilateral event was opened by the heads of the three international agencies (IPW, Public Health, 8 July 2013).

Brittany Ngo is currently completing her Master’s in Health Policy and Global Health at the Yale School of Public Health and previously obtained a Bachelor’s of Arts in Economics from Georgetown University. Through her studies she has developed an interest in health-related intellectual property issues. She is a summer intern at Intellectual Property Watch.