Monday, February 15, 2010

PLoS Medicine Debate on Medical Patents

The most recent issue of PLoS Medicine contains an article with three mini-essays regarding the debate “Are Patents Impeding Medical Care and Innovation?”.

In a nutshell, I would say this paper describes four main arguments from those who argue for refinement of the current patent system for drugs and medical devices. First, drug companies only develop a small proportion of drugs for diseases affecting developing counties. Second, many existing drugs are often too expensive for use in developing counties. Third, pharmaceutical companies are producing relatively fewer drugs at higher cost, and some attribute this to patent law. Fourth, patents can dissuade newcomers from developing technologies in a market that already contains patented products. There are other arguments that have been made against certain types of medical patents, but I think these are the four main arguments discussed throughout the article. Of course, proponents of medical patents argue that patents are necessary in order to provide the proper incentives for innovation.

Evidence within the article (especially by the author of the second mini-essay) indicates that patent law may not be responsible for the third argument (fewer new drugs at higher cost) and the fourth argument (barriers to entry/innovation) may be exaggerated. Furthermore, I think the fourth argument applies to all industries, at least to some extent. Therefore, I will mostly focus on the arguments regarding the impact of patent law on developing countries.

The authors of the third mini-essay cite “malaria, pneumonia, diarrhea, and tuberculosis…account for 21% of the global disease burden, [but] receive 0.31% of all public and private funds devoted for health research.” I think the fact that the problems of developing countries receive a low proportion of funds from both public and private funds indicates that this problem is not completely caused by patent laws. To be honest, I think it makes sense for people to want to spend a higher proportion of their money on problems that directly affect them, so I would probably expect global needs to exceed funding no matter what.

The authors of the third mini-essay provide a good solution to cutting costs of drugs for developing countries. The non-profit Drugs for Diseases Initiative “finances R&D up front and offers the outcome of its research on a nonexclusive basis to generic producers”. Universities also hold the patent on a number of important drugs, so scientists from various non-profit organizations (such as universities) could negotiate deals with companies to produce and sell their drugs at a reduced cost. Although it was not mentioned in this article, some drug companies already offer drugs to developing countries at a reduced cost or donate patents to non-profit organizations.

The author of the first mini-essay mentions that some people believe that a prize system could replace the current patent system. I completely disagree with implementing a prize system to replace patent law, but it is possible that a prize system could complement innovation in the non-profit sector (this is already done on various scales, but more prizes certainly wouldn’t hurt).

That said, I don’t think patent laws are absolutely perfect. For example, I think we may reach a point where limitations need to be set for patents on genetic information. A popular example of this problem (also mentioned in this article) would be Myriad Genetics’ patent on BRCA1/2.

In general, I really like this article format. I wish the mini-essays more cleanly divided into “pro,” “con,” and “unsure” categories, but this is a very minor issue that does not significantly detract from a well-written and organized article. On a different note, I would like to mention that a debate article like this has not been published in PLoS Medicine since August 2009 (although several were published in the months prior to that), and I would personally like to see a lot more articles like this.

I am a huge fan of the PLoS journals in general, and I think PLoS journals make excellent choices for reviews of scientific journal articles in blog entries because they are open-source. So you can definitely count on more PLoS journal reviews from me in the future!

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