Invited Lecture for Canadian Institutes of Health Research & Karnataka Health Promotion Trust's International Infectious Disease & Global Health Training Program

1. GLOBAL PHARMACEUTICAL R&D
Some Political-Economy & Public Policy Considerations
CHIRANTAN CHATTERJEE
IIM-Bangalore
Sept 1 2014
International Infectious Diseases & Global Health Training Program
Karnataka Health Promotion Trust
Sources for data & figures: World Wide Web (unless otherwise mentioned)

2. Do you believe that New Medicines
are Good for Society?
Source: Lichtenberg 2005

3. New Medicines Seem to be Good for
Society
Source: Lichtenberg 2005

4. But New Medicines are costly raising
Affordability Issues: Case of Antiretrovirals
Source: http://apps.who.int/medicinedocs/documents/s18716en/s18716en.pdf

5. How can you balance Access versus Innovation
in Pharmaceutical R&D?
- Solutions?
- No Easy Answers
- Innovator Firms Focus on R&D spending in
therapeutic markets (usually in rich-world
diseases) that give them returns on R&D with their
monopoly rents protected through patents.
- But when poor needs those drugs like in HIV or
Cancer, patents are often side-stepped, causing
tussles between innovators & imitators, developed
and developing countries.
- But if patents are disrespected, no innovation
might happen

6. A Classic Egg-Chicken-Egg Public Policy
Problem

7. Boiling into Policy Disputes between Countries

8. What Might be a Solution? Some Policy Levers
1) Stronger Patents in Developing & Least
Developed Countries?
2) Compulsory Licenses?
3) Differential Pricing?
4) Advanced Market Commitments as in case of
Vaccines?
5) Priority Review Vouchers?
6) Health Impact Fund?
7) ALS Ice-Bucket Challenge?
8) Any thing else?

9. TRIPS & Global Public Health

10. Compulsory Licensing

11. Differential Pricing
Source: Chatterjee, Kubo, Pingali 2014

12. Differential Pricing
Source: Chatterjee, Kubo, Pingali 2014

13. Advanced Market Commitments

14. Priority Review Voucher (Ridley et.al)
Drugs for Neglected Diseases
https://www.youtube.com/watch?v=LSlF4hT8TYg

15. Health Impact Fund
Thomas Pogge – Yale University
https://www.youtube.com/watch?v=7HLLq-FY57I

16. ALS Ice-Bucket Challenge
A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?

17. ALS Ice-Bucket Challenge
A Developed World Fad or a Real Panacea to Finance Pharmaceutical R&D?
Source: http://www.vox.com/2014/8/20/6040435/als-ice-bucket-challenge-and-why-we-give-to-charity-donate

18. Some Other Considerations Here
 Universal Health Coverage & Government Funded
National Health Insurance Schemes?
 Price Control of Drugs?
 The role of Low-End Disruptors?
 State Procurement Agencies like TNSMC/Locost (Public or
Private)?
 Quality of Medicines/Counterfeit/Banned Medicines?
 Role of Alternative Medicines (the search for Sanjeevani)
 Biologics & Bio-similars?
 Anything else?

19. So No Answers from me – Still Mulling!
- But maybe one needs to think about:
 A Tiered Therapeutic Market Approach.
 Contemplate the role of Innovation
Prizes (like PRV, HIF)
 A Straight-Up Patents/No-Patents World
might not be a solution

20. Giants on Whom we Stand
(and there are many)
 Joseph Stiglitz, Boldrin & Levin
 Jenny Lanjouw (ex-UC Berkeley), F. M. Scherer (Kennedy-Harvard), Iain
Cockburn (Boston-U), Henry Grabowski & Frank Sloan (Duke-U),
Richard Manning (Bates & White)
 Pinelopi Goldberg (Yale), Anita McGahan (Rotman-Toronto), Margaret
Kyle (Toulouse U.), Yi Qian (UBC-Northwestern), Panle Jia (Cornell),
Antara Dutta (Bates & White)
 Dana Goldman, Tom Philipson, Darius Lakdawalla, Neeraj Sood
(USC/Precision Health Economics)
 Ashish Arora (Duke), Lee Branstetter (Carnegie-Mellon), Matt Higgins
(Georgia Tech), Mariko Sakakibara (UCLA)
 Sudip Chaudhuri (IIM-Calcutta) and Shubham Chaudhuri (World Bank)
 And some others who are on this journey to unravel this puzzle like me.

21. Thank You for your time
chirantan@alumni.cmu.edu or
chirantan.chatterjee@iimb.ernet.in