Open Source Open Pharmaceuticals Lincoln Stein Cold Spring Harbor Laboratory Ideas from Tim Hubbard & James Love AIDS Crisis in 3d World Treatment Unaffordable Complex Reasons o Promised contributions from developed world not forthcoming o Use of generics blocked o TRIPS agreement (trade related aspects of IP) enforces 20-year patent on most recent anti-retrovirals o USA refusing to fund purchases of older generic drugs manufactured in India Domestic Concerns Drug prices are increasing faster than inflation Drugs are Lion’s Share of Recent Health Care Increases Pharmaceutical Economics o o o o R&D is expensive Marketing is expensive Manufacture & distribution is cheap Long lag time (3-5 yrs) between research investment and bringing product to market Patent Protection o Patents protect companies’ R&D investment. o 20-year exclusive license. o IP trade agreements (TRIPS) protect pharmas against international freeloaders. o System very effective at developing new drugs. Distorting Effects of System o Strong incentive to develop “me too” drugs. o Strong disincentive to develop drugs for neglected diseases. Therapeutic benefit, 24% 1,035 new drugs approved by FDA, 1989-2000. Source: NIHCM Neglected diseases, 1% No significant therapeutic benefit over existing drugs, 76% Incrementally Modified Drugs Pay Off Better NME new molecular entity IMD incrementally modified drug Priority shows therapeutic improvement over existing drugs Where Drug Sales Go Other, 4% Taxes, 6% R&D, 11% Marketing & Just 2-3%administration, of drug sales 31% to finance R&D on drugs that are of therapeutic benefit over existing drugs. Profit, 16% Production, 32% Compiled from quarterly reports & FTC filings of 6 pharmas, 1999. Source: Boston University School of Public Health go Is There a Better Way? Software Economics o o o o R&D is expensive Marketing is expensive Manufacture & distribution is cheap Long lag time (2-3 yrs) between research investment and bringing product to market Software Market is Distorted BLAST Closed Source Financing Commercial R&D copyrights Software Production & Marketing software sales Academic R&D Public sales tax income tax grants Government money knowledge Open Source Financing “Volunteer” R&D source code grants & contracts Service Service Service Companies Companies Companies service contracts source code Academic R&D Public taxes grants Government money knowledge Open Source Benefits o High quality software o Low cost to consumers o Large after-market/service & support segment o Enables “orphan” software o All of bioinformatics is open source! o (CGI.pm, BioPerl, GMOD project) Current Drug R&D Financing Commercial R&D patents Drug Production & Marketing drug sales orphan drug incentives Academic R&D grants Public sales tax income tax FICA grants Government money knowledge Open Source Drug R&D? Generic GenericDrug Drug Generic Drug Companies Companies Production Commercial R&D generic sales applied research grants Academic R&D basic & applied research grants Public Savings sales tax income tax FICA health insurance Government money knowledge Benefits o R&D direction set by public health priorities, not by marketing priorities o No incentive to create “me too” drugs o Less marketing overhead o More competition on production & distribution o Lower prices o Generics available sooner to 3d world countries Can Government do Drug R&D? o Government can direct drug development when it wants to o Retroviral protease inhibitors o Polio vaccine o Hundreds of complex clinical trials funded by NIH and managed by academics Can Government Afford It? health insurance premiums Health Insurance Funds payouts Public savings Cheap Generic Drugs Open R&D Let’s get Real o Not a chance USA will adopt this model. o Must we force rest of world to follow suit? Global Considerations o TRIPS agreement forces all but the least-developed countries to honor 20-year patent rights o It discourages experimentation with alternative financing models o It hurts 3d world countries by denying them access to affordable & effective generics A Better Alternative o Ditch TRIPS o Allow overseas generic development o Let countries exercise compulsory licensing of patented drugs o Discourage freeloaders by o requiring WTO signatories to devote fixed %age of GDP to drug R&D o punitive tariffs on reimported generics It is our Moral Obligation