The inadequacies in the current system, suggest Hubbard and Love, are a consequence of a business model that uses a single payment to cover both the costs of manufacture, marketing and sales of a drug and the cost of the research and development (R&D) carried out by manufacturers to discover it. The current system is supported by a vigorously-enforced intellectual property regime, which protects the financial interests of companies and reaches across borders so that poorer countries cannot develop cheaper versions of the drug.
Aside from the inadequate availability and high price of drugs, other unwelcome side-effects of the existing business model are a lack of information sharing amongst researchers, and a consequent reduction in the pace of discovery. There are also strong incentives to develop drugs that have little if any increase in efficacy over existing drugs--so-called me-too drugs. And it is not surprising that many of the major global health challenges, which tend to affect poorer nations, receive short shrift from companies that focus their attention on more lucrative health markets.
So what's to be done? Hubbard and Love propose that the markets for R&D and the markets for products should be separated. Researchers and drug developers would be compensated, but not through a marketing monopoly. Large cash prizes to successful firms or non-profit drug developers, direct public sector involvement in drug development, new open collaborative development models, or government imposed research mandates would be possible economic models for funding drug development.
Contact: Barbara Cohen
Public Library of Science