As a former consultant to the pharmaceutical industry, I used to think a lot about what the industry could do better, particularly since it tends to have a fairly negative reputation overall. In particular, I’ve wondered how they can research and develop drugs for non-profitable disease states. For example, CIDP is a rare subset of a rare autoimmune disease. While it is incredibly debilitating, there is no known cure, in part because fewer than 15 patients are diagnosed each year. At the other end, you’ve got conditions like Chagas disease. It effects millions, but the current treatments are pretty basic and, as of late, have been shown to not wholly cure the patient. But with most of the affected population living in Latin America, the chances of recouping high R&D expenses for a Chagas cure are low. What is pharma’s responsibility to explore treatments for diseases that have unprofitable populations?
Enter One World Health (www.oneworldhealth.org). While they fall in the LDC/Non-profit category, I think the opportunity for big pharma (and getting-bigger biotech) to partner with them (or adopt a similar model) is a fascinating opportunity. But one of my questions is, based on the sizeable R&D budget to develop any drug does such a venture need to be non-profit?
For the record, there is pharma-non-profit partnership. Celera donated an early-stage compound to One World Health that they thought could treat Chagas disease. While it didn’t work out due to adverse events in the clinical trials, it’s still an interesting model, and perhaps this is a good way for pharma to be simultaneously socially responsible to both its investors and the rest of the world. At the same time, this raises another question for me: if a firm is in the business of directly advancing the social good, how far do their social responsibilities extend? Is Celera’s donation good enough, or should they be funneling their own profits into R&D for a compound that, even if it is successful, will not likely be profitable? In the context of “Omelas,” if a company is helping everyone but the child, where do they stand?
I think there is a role for the government to play here. As an example given by Bill Gates in his speech (http://www.youtube.com/watch?v=Ql-Mtlx31e8 -at around 17 minutes) delivered at the World Economic Forum. There is a law recently signed by Bush administration where if a pharma company develops a new treatment for a neglected diseases like malaria and typhoid then they can advance their FDCA approval for another drug of their choice by up to an year. Such a policy may result in a some other drug such as cholesterol lowering drug getting to the market quicker saving several millions of dollars for the company.
ReplyDeleteSo for profit, non-profit and government can come in together to promote market based incentives for advancing the social causes.
That's a really interesting solution. I like the idea of the three groups (for-profit, non-profit, and government) working together to solve these problems, but I'd also still make the argument that it'd be to the benefit of society if that additional drug (e.g. combating high cholesterol) got faster approval anyway. I'm certainly taking the positive-pharma argument, but it would save the company money and help patients. Just because a drug makes money for a company doesn't make the company or the drug not valuable to society. (I know that wasn't your argument, Amarjeet, but it's a corollary to the question of whether pharma acts socially responsibly.)
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