E-DRUG: Dorette Corbey (MEP) on R&D for neglected diseases
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[Members of the European Parliament are raising their voices about neglected diseases. Mrs Dorette Corbey, MEP for the Socialist fraction, prepared this speech for the HAI meeting "Priority Medicines: setting priorities, missing the point", 18 Nov in The Hague, Netherlands. On her website (www.corbey.nl) there is also an interesting paper "Medicines in a global context, A plea for public leadership". See http://www.corbey.nl/Medicines_in_a_global_context.pdf
WB]
LET4S MAKE PEOPLE BETTER
19-11-2004
Let's make people better
Drug development takes place within mostly western private industries, directed to high profits, targeting all kinds of typical western lifestyle problems, like obesity, lack of libido or excess of cellulite. Discussing the pharmaceutical industry and the market of medicines means discussing billions of dollars (and euros) in profit every year. Currency, which is mostly invested in marketing as opposed to research & development. And this is exactly where we need to step in. Or better: where national governments have a responsibility to intervene.
It is a frustrating situation: so called 'neglected diseases' do not receive the same attention of the pharmaceutical industry as compared to the diseases that affect the western world. Neglected diseases are not considered profitable, and as a result research & development does not spontaneously take place. There exists a wealth of knowledge on tropical diseases, yet, only a small fraction, if there is any, finds its way to the development of new drugs to combat these diseases. For example, the diagnostic test for tuberculosis, still in use in most developing countries, dates back to 1882 and only detects about half of the people with TB. It is this disease that causes 2 million deaths and there are 8 to 9 million new infections every year. You've got AIDS? You suffer from sleeping disease? You are infected with tuberculosis? Too bad you were not born in Europe or the States, because maybe then it would have been on the research agenda of pharmaceutical companies. Or in the case of AIDS, the disease is on the agenda but the treatment of children infected with the virus does not receive sufficient attention because only few children in wealthy countries contract the virus.
Needless to say we need to keep reminding the pharmaceutical industry of the importance of research on these diseases, to remind them that they are in the position to make a difference, that they have the knowledge and expertise to develop solutions, and moreover that they need to take responsibility.
However, the main problem is that the pharmaceutical industry is profit driven and public interests are merely addressed as a secondary effect. Companies choose low-risk strategies concentrating on blockbuster medicines and so called me-too drugs. This me-too attitude hampers true innovation and this does not seem to be the right approach.
In short, the problem is:
* First; the development of drugs does not reflect public needs.
* Second; at the same time competition intensifies, meaning: marketing budgets are rising, new drugs are directed at profitable markets adding little therapeutic value.
* And finally, as the HAI brochure states, there is a risk that this fierce competition will lead companies into unfair or less fair practices.
What to do?
Public responsibility is what we need. While some public services have been privatised, the opposite should be the case for certain segments of the pharmaceutical industry. Certain activities, currently performed by pharmaceutical companies, should be performed by
public actors. Of course it is hardly conceivable that governments start developing drugs themselves.
Possibilities we should think about are: a framework directive for neglected diseases that creates the right incentives for the industry. We should carefully look at GPPIs (so called Global Public Private Initiatives) and also evaluate the incentives for priority medicines. Finally, I would encourage you to think about a more radical solution: a ban on all marketing for the pharmaceutical industry. In that case, governments will be responsible for providing objective information to those in charge of prescribing medicines: for example, by developing special websites with information from independent sources. Doctors will then have the possibility to make their choice based on fair and objective information and the influence of the industry on regulators will be diminished.
The impact will be all-round and far-reaching:
- more concentration on neglected diseases and on real innovative products instead of me-too drugs that add little value
- more funding available for research because companies can cease to compete with each other with marketing strategies and budgets
- and a fair presentation of the benefits and risks of medicines.
Of course we are aware that this proposal is very controversial, but it remains challenging to think of a world with less marketing. A small start could be to agree on a selective ban on marketing for priority medicines.
I would like to end this statement with the reformulation of a well-known marketing sentence: For once, let's make people better.
BS