Changing current models to improve patient access to innovation
"There's not one fix" to ensuring patient access to innovative medicine. That appeared to be the consensus of moderator Christi Shaw, president, Novartis Pharmaceuticals Corporation and panelists, discussing the opportunities and challenges in getting new therapies to patients with complex and chronic conditions like cancer, multiple sclerosis and rheumatoid arthritis during a super session today at the BIO International Convention.
Is the cost of some drugs a barrier? Are we adequately pricing the value of innovation? To ensure breakthroughs continue to reach patients, Scott Gottlieb, resident fellow, American Enterprise Institute, suggested that we need an approach to financing care that's as modern and as imaginative as the medicines that are being invented. "The science has advanced enormously but our financial provisions for funding delivery of these drugs haven't changed for decades," he said. Policy obstacles are preventing experimentation with how drugs are priced.
The optimal solution to increase access to new therapies is to price the drug at the cost of production, essentially give it away but innovators should be rewarded, noted Dana Goldman of the University of Southern California. "In the U.S., we want to encourage innovation but there's a trade-off between low prices and innovation." There's a fundamental misunderstanding with price, Goldman argued. For example, innovators received just five percent of the return with HIV drugs and the rest went to patients. When the debate "focuses just at price of drugs, patients don't get treated," Goldman said.
"We need to look at totality of what benefits patients," added John Clymer of the National Forum for Heart Disease and Stroke Prevention. "Access to quality health care is only 10 percent of the picture. Sixty-percent is social determinants; where you live, work and play." He explained that the U.S. continues to spend 17 percent of GDP, but ranks low among industrialized nations in health outcomes, suggesting the system is designed to produce these results. "Middling performance is on par with middling investments." Patient engagement matters and a greater participation in clinical trials to help reduce health disparities will help close gaps in quality care, Clymer added. Other panelists noted that the current system is set up to drive companies to make expensive medications for small populations. "We're not applying the same amount of energy to fighting the most pervasive diseases," said Richard Pops, chairman and CEO, Alkermes, Inc.
The panel also discussed the need to provide more incentives to innovators and incentives to patients to improve adherence to medication. Current incentives are aligned to make it cheaper for patients to wait until they're in an acute situation to seek treatment, they noted.