Our Drug Patent Tragedy, and a Provocative Alternative

It’s been a truism for decades that only strong patents can give drug companies sufficient incentive to take on the long, risky work of developing new drugs. But now this truism about drug R&D is being shattered – by the realities of what strong intellectual property rights in trade agreements are actually delivering (not much) as well as by their morally repugnant results. The sick and poor people who need drugs for life-threatening ailments can’t afford them (provided they are made in the first place) – while the drug industry cranks out lots of new “lifestyle” drugs for sexual performance, baldness and less urgent health concerns.

Activist Jamie Love of the Consumer Project on Technology and Tim Hubbard of the Wellcome Trust Sanger Institute in the UK recently presented a bold new proposal that promises to break the trade-off between drug innovation and patient access to drugs. (In general, the stronger the intellectual property trade rules for drugs, the higher the prices – and therefore the less affordable to the poor people who need them. This is the crux of the problem of African access to AIDS drugs.)

Love and Hubbard propose a brilliant new legal and financing framework for sharing the costs of drug R&D on a global basis. Their proposal, “A New Trade Framework for Global Healthcare R&D,” appeared in the February 2004 issue of the new open-access journal, Public Library of Science Biology. Another account of their idea can be found in Bridges, published by the International Centre for Trade and Sustainable Development.

Love and Hubbard point out that the astonishing inefficiency of the existing patent system in funding therapeutically significant new drugs. Only 10-15% of the $430 billion in drug industry revenues is actually spent on R&D, they write, and only 2-3% of that R&D sum is actually spent to develop new medicines with therapeutic benefits over existing ones! More than 75% of new drugs approved by the FDA between 1989 and 2000 are simply “me-too” drugs that are regarded as having no therapeutic benefit over existing products. The most important new drugs come from funding by the National Institutes of Health, which receives about $100 from every US taxpayer….but the drug discoveries made by NIH researchers are generally given away to the drug industry for a song.

In their path-breaking proposal, Love and Hubbard suggest that every nation pay an equivalent share of their Gross Domestic Product into a global drug R&D pool to ensure that the R&D burden is shared equally. The Love/Hubbard proposal would not only ensure greater fairness, it would foster a more decentralized R&D infrastructure that can work openly and collaboratively (like the Human Genome Project and enable greater technology transfer to less developed nations. It would also allow individual nations to target public health priorities such as malaria and other neglected diseases without running afoul of patent and trade rules.

“Strong IPR [intellectual property rights] models are imploding even in the United States and Europe,” write Love and Hubbard. “We must find ways to avoid the rationing, the costly inefficiencies and the corruption of the scientific and medical professions – and to promote more pen science in order to promote greater innovation.” Love and Hubbard will surely encounter resistance to this idea, but it is surely one of the most compelling, ingenious and coherent ideas for moving beyond the current morass.