Three Proposals for Rewarding Novel Health Technologies Benefiting People Living in Poverty: A Comparative Analysis of Prize Funds, Health Impact Funds and a Cost-Effectiveness/Competitive Tender Treaty

Abstract

The moral and practical problem of how poor people will continue to gain affordable access to medicines is one of the most pressing issues currently confronting humanity. This is not just because of the large numbers of people, in both developed and developing nations who we now have good evidence are dying prematurely for lack of such access (particularly in groups such as children and the elderly). It is also an urgent issue because the regulatory incentives for pharmaceutical research and development (R&D), which particularly include domestic patent regimes and intellectual property provisions in international trade agreements do not favour an output focus directly related to impact on the global burden of disease.

This paper sets out to analyse three different academic proposals for addressing this situation in relation to new, rather than 'essential' medicines. It focuses particularly on (1) research and development prize funds, (2) a health impact fund (HIF) system and (3) a multilateral treaty on health technology cost-effectiveness evaluation and competitive tender. It compares the extent to which each responds to the 'market fundamentalist' philosophy (that we maintain forms a loose theoretical background for the patent-driven approach to pharmaceutical R&D) and begins to analyse their respective strengths and weaknesses.

Keywords: Trade Agreements, Intellectual Monopoly Privileges, Pharmaceutical Policy, Poverty, Cost-Effectiveness, Tender Systems, Health Technology Assessment