R&D and Innovation
(Quoted from Doctors Without Boarders/MSF, http://www.msfaccess.org/main/access-patents/introduction-to-access-and-patents/patents-and-innovation/)
Research and Development as a Justification for High Prices
Pharmaceutical companies and many governments argue that regardless of their impact on drug prices, patents are necessary for research and development (R&D). Charging higher prices, so the argument goes, allows them to get a big financial return on their investment, and they can then re-invest in more R&D. Without patents in other words, there will be no innovation.
This is easily disproved. Africa accounts for some 1% of the world's medicine market. Even if the big pharmaceutical companies ended up making no sales on the continent, their profits - and therefore the money available to them to invest into R&D - would be only negligibly impacted. Their ability to generate income to perform more research depends overwhelmingly on sales in wealthy markets. Yet patents are pursued just as vehemently in developing countries as they are in wealthier nations.
Twin problems, one solution: tackling innovation and access together
R&D into medicines is expensive, and someone has to pay. But in today's world, that person is the patient. The predominant system for drug development today has two deadly effects, then: high prices on the one hand, and the lack of R&D into diseases of the poor on the other.
If the world is to come up with a way of developing medicines which makes sure that those who need them can access them, we will therefore need to look at both medical innovation and access to medicines at the same time.
International talks currently underway at the World Health Organization are seeking to do just that. The Intergovernmental Working Group on Public Health, Innovation and Intellectual Property, or IGWG, was established by member states of the World Health Organization in 2006 to tackle the problems with the current access to medicines and R&D environments.
The working group is groundbreaking as it is the first high-level international body to consider both R&D and access to medicines issues at the same time.
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- Patient care has often been influenced by the relationship between the pharmaceutical industry and medical professionals.
In order to sell their products, doctors are often indirectly bribed with expensive gifts, cash and high paying contracts. This type of manipulation has been highlighted by the American Medical Student Association (AMSA) they have a dedicated team called the PharmFree Campaign who specialize in investigating this type of corruption. They conduct an annual check on all policies within the United States pharmaceutical academic medical centers. They believe that proper education will assist in reducing the number of professionals whose healthcare decisions are influenced by bribery. One of the main areas they investigate is whether medical schools are teaching their students about drug development such as tianeptine sulfate dosage, as well as the ethics associated with the relationships between the physicians in the industry.
Recently, a considerable amount of attention has been directed towards the relationships between physicians and the industry. Advocates believe that medical schools should be preparing students to deal with such interactions. The AAMC Task Force recommend that the curriculum within teaching hospitals should be strategically structured in such a way as to educate students in all areas of the medical profession, including clinical testing and development. The Institute of Medicine believe that teaching hospitals and academic medical centers should educate their students on how to manage relationships and conflict of interest with the representatives from the medical device and pharmaceutical industry. Such topics should be required as a part of formal education.
A global survey conducted by the World Health Organization (WHO) and other bodies within the industry, discovered that out of the 137 medical schools who participated, 74 percent claimed that educating students about drug promotion was a part of the curriculum. On the other hand, only one third of schools spent between one and two hours teaching about drug promotion. These numbers get even smaller within the United States, only 30 percent of schools taught about the impact the medical practice has on the industry, and how to manage conflict of interest. If they did teach about it, the teaching was limited to a review of the school’s policies. These surveys highlight the lack of education medical students are receiving about the inner workings of the industry that they will be employed by.
The AMSA are campaigning for medical schools to adapt their curriculum so that it prepares students to handle the industry in a way that provides protection for patients, public health promotion, and the preservation of the public trust in the healthcare industry. There are many complexities within the relationship between the industry and the physician, and it has a direct and indirect effect on the health care industry in several different ways. While what has been suggested are mere recommendations, AMSA stands by their belief that a strict curriculum that implements these subjects will provide students with the knowledge they need to effectively handle their interactions with the industry once they are employed.
- World Health Organization (WHO) on Public Health, Innovation, and Intellectual Property
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