Posted by: ihfgeneva | December 8, 2014

Innovation and Access to Medical Technologies: Challenges and Opportunities for Middle-income Countries

WTO-WIPO-WHO Joint Symposium, 5 November 2014, Geneva, Switzerland

On November 5, 2014, the World Health Organization, World Intellectual Property Organization, and World Trade Organization held a joint symposium on innovation and access to medical technologies for Middle-Income Countries. The symposium covered the validity of using income ratings in public health, policies designed to unite economic growth with universal health coverage, unique challenges facing specific countries, and ways to promote innovation and guarantee access to medicines for those in need.

symposium speakersOpening remarks established the primary goal of the partnership as facilitating appropriate trade related to public health, respecting intellectual property and incentivizing innovation in the field while guaranteeing access to resources for vulnerable populations. One focus of the symposium was the issue involved with using World Bank income classifications, which use the gross domestic product (GDP), to assess a country’s capabilities in the field of public health: it does not take into account income inequality or variety in the burden of disease within and between those countries. The first session, “Setting the scene,” expanded upon this, with speakers underscoring the importance of strong institutional framework to ensure exchanges remain beneficial and asserting that a new index is needed to determine both health needs and a country’s true ability to pay.

The second session, “Trends in medical technologies innovation in MICs,” began by emphasizing that Middle-income countries’ diverse perspectives, needs, and experience can uniquely spur innovation. Vijay Raghavan, the Secretary of India’s Department of Biotechnology, provided perspective from the Indian industry. While providing 20% of the volume of the global generics market, it is an “under-leveraged global brand,” frequently neglected, over-regulated, and over-taxed. Uncertainty in intellectual property rights, clinical trials, and regulations deter companies from pursuing greater opportunities in India. Mr. Raghavan also touched upon the success of the Biotechnology Industry Research Assistance Council (BIRAC), which works to strengthen innovation and enable biotech entrepreneurship in India’s market.

Peter Chun, Chairman of EASE-MEDtrend Biotech in Shanghai, presented on trends in medical technology innovation in China. Primary challenges for hospital care delivery include the large population and travel distances, which create a demand for rapid diagnosis and care that does not require follow-up. The government’s reimbursement schedule is hugely influential on tech development. To be marketable, innovations in test technology must be within a certain price range; lower reimbursement rates force companies to produce locally or to innovate and miniaturize their technology. Recently, the government has updated the regulatory process, facilitated outsourcing to make development easier, and fostered collaboration platforms to encourage rapid development.

During the third session, “The challenge of ensuring access to medical technologies in Middle-income countries,” Chua Hong Tek, Director of Healthcare National Key Economic Area in the Prime Minister’s Delivery Unit, Malaysia, presented on access to medical technology in Malaysia. They hope to grow their market market with a three-pronged approach: localization and upgrades, creating an export platform, and collaboration between local manufacturers and multinational corporations. The government has enacted initiatives such as the National Medical Policy, ensuring zero GST for drugs on the essential drug list, and has incentivized development of “orphan drugs” for less prevalent diseases by fast tracking registration and waiving bioequivalence studies. They plan to further promote health trades and amendments to patents for better access to medicine.

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Manica Balasegaram, Executive Director of Médicins Sans Frontières’ Access Campaign, suggested a “3P” proposal for improving access in MICs: push, pull, and pool, for strategic investment. This means to push funding through traditional grant schemes, to pull for innovation with end-game potential incentives, and to pool by aligning incentives to encourage the sharing of information. The goal is to address market failures and broaden vaccines and protective medicines.

Wim Leereveld, Founder and CEO of Access to Medicine Foundation, was the final presenter of Session 3. He discussed their “Access to Medicine Index,” rating pharmaceutical companies on how well they promote access to medicine internationally, addressing access from the side of the industry. He highlighted that price is the most important thing for access.  The Index provides a sense of how well companies organize to reach Middle-income countries, how their patents and licensing changes in different environments, and whether they are offering equitable pricing for products in MICs.

The symposium closed with remarks on incentivizing innovation and on middle-income classifications, as well as on cooperation amongst various institutions of health, trade, and innovation. Can the so-called “middle income trap” be escaped through innovation? Moving forward, collaboration is key, as is gathering data and looking at practical experience to positively increase access to medicines and innovation in Middle-income countries.




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