PRIVATE PATENTS AND PUBLIC HEALTH

esearch, that ensure transparency of clinical trial results to enable
independent assessment of the value of a product and, perhaps most
importantly, that include new models of financing drug development.
Pricing of medicines should reflect public investment in innovation to
prevent a situation where the public pays twice: through government
funded research and then again through high drug prices. New models
also will need to address the monopoly-based pricing that today leads to
rationing of important medicines. In the words of the Financial Times:
“… the licence to manufacture a treatment exclusively is not the same
as one to print money. New medicines cannot come at any price —
especially when the maker uses its legal monopoly to set swinging
charges for vital remedies. Doctors do not wish to withhold drugs that
can save lives. But there is a limit to what stretched healthcare
systems can afford.” 319
DELINKAGE MODELS: A WAY FORWARD
One proposal to solve the innovation/access challenge is to ‘delink’ the
cost of the R&D from the price of the product and develop new ways to
share the burden of innovation cost internationally. A joint WTO, WIPO,
WHO study describes delinkage as follows:
“One important concept that evolved from this discussion is the
concept of delinking price of the final product from the costs of R&D. This
concept is based on the fact that patents allow developers to recoup the
costs and make profits by charging a price in excess of the costs of
production. This way of financing R&D is viewed as constituting a barrier
to access to medicines in countries where populations pay out of their
own pockets for medicines and thus cannot afford to pay high prices. The
principle of delinking is based on the premise that costs and risks
associated with R&D should be rewarded, and incentives for R&D
provided, other than through the price of the product.” 320
If, for example, the R&D cost of new cancer drugs would not have to be
recouped through high drug prices in a few countries, those medicines
321, 322
would cost less and would be more widely available.
Several proposals for an international agreement on medical R&D to
achieve the objectives of financing for innovation and access to those
innovations have been made since 2004 (see Box 20). 323
130
6
FIXING THE BROKEN R&D SYSTEM: ENSURING ESSENTIAL INNOVATION AND ACCESS TO MEDICINES FOR ALL