Biology Reference
In-Depth Information
Fig. 9.2
The Health Impact Fund
improve public health (Hunt
2009
: paragraph 35). Pharmaceutical companies
respond to incentives. Current incentives for innovators - above all, patents - do
not align fully with their primary task. Pharmaceutical research is currently con-
centrated on diseases and ailments of the rich; considerable funds are spent on
marketing and litigation (see below) and only a limited match is achieved between
research and the
global
disease burden. The HIF, by linking rewards for innovation
to an effect on the global disease burden, would aim for a better match. Only inno-
vators who make a positive impact on the global disease burden could be rewarded
through this alternative system. Figure
9.2
illustrates the HIF reform plan.
The HIF would be funded by governments and make annual payments to phar-
maceutical innovators who sell their patent-protected product at a price equal to
the lowest feasible cost of production and distribution.
9
The basis on which
rewards would be paid would be the measured health impact of the product. Such
impact could be measured in terms of 'quality-adjusted life years' (QALYs), a
standardized measure for assessing health interventions.
10
Thus the health impact
of a drug could, for example, be approximated as the number of units sold multi-
plied by the estimated incremental QALY benefit per unit. With this basic idea, the
HIF seeks to remove or ameliorate the problems of the current international intel-
lectual property rights system set out in Table
9.3
.
9
The price could be set in various ways. If, for example, manufacture of the product was allo-
cated by tender, the innovator (or owner of the rights to the product) could then sell the product
on at the price paid for its production, without any mark-up. Alternatively, and depending on the
degree of competition in production, the HIF might determine the price by estimating the cost of
production (see Hollis
2009
).
10
Other measures are possible. For example, Michael Selgelid (
2008
) suggests that the DALY
(disability-adjusted life year) approach might be preferable for the purposes of the HIF in that it
quantifies relief from the burden of disease.
