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Papers on Prizes and Other Proposals for More Accessible Medical Innovation

CPTech PAPERS ON PRIZES FOR MEDICAL INNOVATION

March 26, 2007. James Love and Tim Hubbard. The Big Idea: Prizes to Stimulate R&D for New Medicines. KEI Research Paper 2007:1. Adapted from the Ruby Hutchison Memorial Address, Nov. 12, 2006.

March, 2007. James Love. Measures to Enhance Access to Medical Technologies, and New Methods of Stimulating Medical R&D. UC Davis Law Review. 40(3):679-715.

May 2006. James Love. Drug development incentives to improve access to essential medicines. Bulletin of the World Health Organization. 84(5).
One page paper describes drug scarcity as a choice and proposes a Medical Innovation Prize Fund and new global trade framework as alternatives that better accommodate a human right to essential medicines.

May 2006. James Love, "A new initiative at the WHO, Prizes rather than prices." Le Monde diplomatique.
Describes the diplomatic path leading to the acceptance of a WHO resolution to convene the Inter-Governmental Working Group (IGWG). The IGWG will consider a global strategy for promoting, focusing, and making more accessible the products of medical R&D.

March 2006. James Love. "Measures to Enhance Access to Medical Technologies, and New Methods of Stimulating Medical R&D." Paper for the WIPO Open Forum on the draft Substantive Patent Law Treaty (SPLT). See also:
2005. James Love. Medical Innovation Prize Fund System of Remuneration. In Remuneration Guidelines for Non-Voluntary Use of a Patent on Medical Technologies. James Love. WHO UNDP. 77-80 and 101-104.
Includes a section on an international medical innovation prize fund. Considers levels of prize contribution by countries of various incomes, as well as the compatibility of such a fund with the TRIPS Agreement. Table A-3 in the appendix of the UNDP paper provides the amount each country would contribute to an international prize fund under a proposed sliding scale model.

June 1, 2005. James Love. Two Ideas Regarding Innovation and Access. Presentation for the WHO Commission on Intellectual Property Rights, Innovation and Public Health Open Forum.
Presentation reviews economic and access-to-medicine consequences of linking innovation incentives to high drug prices. Includes an overview of proposals for a medical innovation prize fund in the U.S. (H.R. 417) and internationally (R&D Treaty), and contrasts these proposals with advance purchase commitment models.

2004. James Love and Tim Hubbard. A New Trade Framework for Global Healthcare R&D. PLOS Biology. 2(2): e52 DOI: 10.1371/journal.pbio.0020052.
Discussion of a global trade framework that would satisfy the objective of preventing R&D 'free-riding' without requiring drug monopolies. Suggests that instead of relying upon monopoly rents, countries could promote drug innovation through the use of prizes or grants.

2003. James Love. A New Trade Framework for Global Healthcare R&D. Paper for Columbia University's Workshop on Access to Medicines and the Financing of Innovations in Heath Care.
Presents several models for promoting drug innovation without patent monopolies, including prizes, direct public funding of R&D, open collaboration, and the use of competitive intermediators.

OTHER PAPERS ON PRIZES FOR MEDICAL INNOVATION

March 2007. Carl Nathan. Aligning Pharmaceutical Innovation with Medical Need. Nature Medicine. 13(3):304-8.

March 2007. Joseph Stiglitz. Prizes, Not Patents. Project Syndicate. See also:
December 23, 2006. Joseph Stiglitz. Scrooge and Intellectual Property Rights: A medical prize fund could improve the financing of drug innovations. British Medical Journal. 333:1279-80. also:
2006. Joseph Stiglitz. Patents, Profits, and People. In Making Globalization Work. New York: W.W. Norton & Company. 103-132. also:
2006. Joseph Stiglitz. Give Prizes not Patents. New Scientist.
Proposes a global prize fund paid for by industrialized nations that would reward new drug and vaccine developments on the basis of their health impact. Argues that using such a prize system in lieu of patent monopolies would be 'more efficient and more equitable.'

December 2006. Thomas Kalil. Prizes for Technological Innovation. Brookings Institution Discussion Paper.

April 18, 2006. Scott Woolley. Prizes not Patents. Forbes Magazine.
Argues for a U.S. medical innovation prize system and describes advantages for American consumers.

June 21, 2005. Thomas Pogge on Online Opinion. A New Approach to Pharmaceutical Innovations.
See also:
January 2005. Thomas Pogge. Human Rights and Global Health: A Research Program. Metaphilosophy. 1/2(36).
Proposes a global reward fund of $45-90 billion per year from which pharmaceutical innovators could choose to apply for payment in lieu of a patent monopoly. Emphasizes the moral as well as prudential rationale for such a system.

May 18, 2005. Aidan Hollis. An Optional Reward System for Neglected Disease Drugs.
Proposes that pharmaceutical innovators be eligible for a share of an approximately $1 billion global reward fund if they chose to open license the patent for their innovation in all developing countries. Proposes a mechanism for determining reward shares for a given drug based on relative social value.

January 17, 2005. Aidan Hollis. An Efficient Reward System for Pharmaceutical Innovation.
Discusses benefits of a pharmaceutical reward system over current patent system. Explains features of the pharmaceutical market that make profits poor indicators of a drug's social value.

August 22, 2003. Burton Weisbrod. Solving The Drug Dilemma. Washington Post Op-ed.
Proposes a prize system for pharmaceutical innovation with an emphasis on increasing efficiency in the American health care system.

CRITICISM OF PRIZES FOR MEDICAL INNOVATION

March 11, 2007. Greg Mankiw. Stiglitz on Prizes.
Very short blog critique expresses concern about prize committees' decision making and whether taxes to fund prizes would be more distortionary than the monopolies they replace.

2007. Marlynn Wei. Should Prizes Replace Patents? A Critique of the Medical Innovation Prize Act of 2005. Boston University Journal of Science and Technology Law (working paper).
Argues that the Medical Innovation Prize Fund Act is too ambitious "relative to the lack of support in empirical evidence." Proposes implementation of a smaller scale pilot prize program to test and perfect the system.

September 22, 2004. Dean Baker. Financing Drug Research: What are the Issues? Issue Brief, Center for Economic and Policy Research.
Argues that a proposed global prize system could face problems with political interference in research priorities.

June 25, 2004. Joseph DiMasi and Henry Grabowski. Patents and R&D Incentives: Comments on the Hubbard and Love Trade Framework for Financing Pharmaceutical R&D.
Argues that a global pharmaceutical prize system would have difficulty with free rider countries and adjusting the size of the fund to reflect changing priorities. Also suggests that a U.S. prize system would be expensive and face pressures to under-fund innovation.

NON-PRIZE PROPOSALS FOR MORE ACCESSIBLE MEDICAL INNOVATION

2006. Ernst Berndt, et al. Advance Market Commitments for Vaccines Against Neglected Diseases: Estimating Costs and Effectiveness. Health Economics. Forthcoming.
Defends the feasibility and cost effectiveness of a proposed advance purchase commitment for vaccines for neglected diseases. Suggests that $3.1 billion would be an adequate commitment for an effective malaria vaccine.

Winter 2006. Rachel Glennerster, Michael Kremer, and Heidi Williams. Creating Markets for Vaccines. Innovations. (1)1: 67-79.
See also:
2004. Michael Kremer and Rachel Glennerster. Strong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases. Princeton University Press. Manuscript: Creating Markets for New Vaccines Part I: Rationale and Part II: Design Issues.
Proposes advance market commitments for vaccine development: donors would make a legally binding commitment to purchase at a specified price large quantities of any vaccine developed that meets certain specifications. Innovators would retain standard patents, but donors would provide purchased vaccine to poor countries at low cost.

2006. Kevin Outterson. "Patent Buy-Outs for Global Disease Innovations for Low and Middle-Income Countries." American Journal of Law and Medicine, Vol. 32. See also:
2005. Kevin Outterson. Fair Followers: Expanding Access to Generic Pharmaceuticals for Low and Middle-Income Populations., and Nonrival Access to Pharmaceutical Knowledge.
Proposal would keep in tact current system in high income countries while encouraging voluntary licensing of patents to generic manufacturers in low and middle-income countries. Patent holders would receive 14-17% of generic units sold times the lowest generic price for licensing.

2006. David Ridley, Henry Grabowski, and Jeffrey Moe. Developing Drugs for Developing Countries. Health Affairs 25(2): 313.
Proposes granting 'priority review vouchers' to developers of treatments for neglected diseases who forgo patent rights. The transferable voucher would entitle the bearer to priority FDA review for an otherwise standard priority drug, with time savings worth an estimated $300 million for blockbuster drugs.

2005. James Love and Tim Hubbard. Paying for Public Goods. In Code: Collaborative Ownership and the Digital Economy. Edited by Rishab Aiyer Ghosh. MIT Press, Cambridge. 207-229.
The second section describes the inefficiencies of market exclusivity for drugs, and proposes an alternative system in which 'competitive intermediators' dispense funds to promote innovation according to the model (prizes, grants, etc.) the intermediator judges to be most efficient.

2005. Owen Barder et al. Making Markets for Vaccines: Ideas to Action. Center for Global Development. Washington, D.C. Draft Report.
Proposes advance purchase commitments for vaccine development: donors would make a legally binding commitment to purchase at a specified price large quantities of any vaccine developed that meets certain specifications. Innovators would retain standard patents, but donors would provide purchased vaccine to poor countries at low cost.

2004. Jean Lanjouw and William Jack. Trading Up: How Much Should Poor Countries Pay to Support Pharmaceutical Innovation. Center for Global Development Brief. 4(3):1-8.
Proposes that patent monopolies be granted for a given pharmaceutical innovation in either developed or developing countries, but not both.

2004. Peter Stein and Ernst Valery. Competition: An antidote to the high price of prescription drugs. Health Affairs 23(4):151-158.
Proposal for the U.S. government to fund R&D to compete with the private sector for pharmaceutical patents, with open- licensing of resulting patents.

2004. Frederic M. Scherer. A Note on Global Welfare in Pharmaceutical Patenting [summary]. The World Economy. (27)7:1127-1142.
After weighing costs and benefits, argues it would be best to permit developing countries to 'free ride' on richer countries' pharmaceutical innovation.

March 4, 2004. Tim Hubbard and James Love. We're patently going mad: Lifesaving drugs must be developed differently - for all our sakes. The Guardian. See also:

June 14, 2003. Tim Hubbard and James Love. Medicines Without Barriers.The New Scientist. And also:
2003. James Love. From TRIPS to RIPS: A better Trade Framework to support Innovation in Medical Technologies. Paper for the Workshop on Economic issues related to access to HIV/AIDS care in developing countries, Agence nationale de recherches sur le sida, Marsielle, France.
Proposes a global trade framework emphasizing countries' support for medical innovation rather than enforcing drug monopolies, which represent only one means to that end. Under the proposed framework, countries would be free to choose from a number of mechanisms for promoting medical innovation.

October 11, 2002. Dean Baker and Noriko Chatani. Promoting Good Ideas on Drugs: Are Patents the Best Way? The Relative Efficiency of Patent and Public Support for Bio-Medical Research. Center for Economic and Policy Research.
Proposes replacing private pharmaceutical R&D in the U.S. with publicly funded R&D with open-licensing of innovations. Claims that this system would be more efficient and largely pay for itself.

2001. Mattias Ganslandt, Keith Maskus and Eina Wong. Developing and Distributing Essential Medicines to Poor Countries: The DEFEND Proposal. Working Paper for the Research Institute of Industrial Economics.
Proposes devoting $8-12 billion per year in foreign aid from developed countries to purchasing license rights to certain patented drugs needed in the developing world. Licensed drugs would be available at low cost to developing countries with a co-pay from local governments and restrictions on parallel trade.

1998. Michael Kremer. Patent Buyouts: A Mechanism for Encouraging Innovation. Quarterly Journal of Economics 113: 1137-67.
Proposes that government offer to buy out pharmaceutical patents using a described auction system to determine price. Patent holders could choose whether or to sell or to retain patent monopolies.

1997. Douglas Lichtman. Pricing Prozac: Why the Government Should Subsidize the Purchase of Patented Pharmaceuticals. Harvard Journal of Law and Technology. (11)1: 123-139.
Proposes a small government cash subsidy for patients who otherwise would not pay monopoly prices for patented drugs. Argues this would increase access more efficiently than patent buyouts, and lead patent holders to voluntarily lower prices.

1995. Robert Guell and Marvin Fischbaum. Toward Allocative Efficiency in the Prescription Drug Industry. The Millbank Quarterly. 73(2):213-230.
Proposal for U.S. government to seize pharmaceutical patents under power of eminent domain and transfer them to the public. Amount of 'just compensation' for patent holders would be determined by judges.

1991. Mark Johnston and Richard Zeckhauser. The Australian Pharmaceutical Subsidy Gambit: Transmuting Deadweight Loss and Oligopoly Rents to Consumer Surplus. NBER Working Paper. 4161.
Proposes offering public subsidies for pharmaceuticals in exchange for lower prices for patented drugs. Total pharmaceutical spending would remain the same or decline while access to drugs would increase.



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