Global Access to Oncology Drugs: Intellectual Property Rights are Key

Around the world cancer patients are struggling to gain access to the cutting-edge therapies that will treat their diseases.  At the same time that oncology is driving growth in biopharmaceuticals, access is increasingly challenging across the globe. This is  evident in the rise in spending on oncology drugs, which reached $100 billion in 2014.[1] According to SCRIP Intelligence, in 2014 oncology represented 14.7% of total drug spending in 2014 in the nations of France, Germany, Italy, Spain and the UK.  In the same period it was 11.3% in the United States. [2]  

Admittedly, the high cost of oncology drugs as a barrier to access is a justifiable concern   and access – even in wealthy countries – is hindered by rising out-of-pocket patient costs and the failure of insurers to reimburse new drugs.  However,  other issues are clearly in play as well. 

International access to oncology drugs is a complex issue, but a drug’s availability is also correlated with the strength of a nation’s intellectual property rights.  As described by SCRIP Intelligence, over the preceding five years, 45 new cancer drugs have been launched globally, addressing 53 indications.  In 2014 alone, ten products were launched including five biologics:  Amgen's Blincyto (blinatumomab), Lilly's Cyramza (ramucirumab), Merck's Keytruda (pembrolizumab), Bristol-Myers Squibb's Opdivo (nivolumab) and Janssen's Sylvant (siltuximab). [3]  However, a product’s launch in one nation does not necessarily mean availability in another. 

Consider the following:  according to a recent IMS report, since 2009, 27 new targeted cancer drugs have been launched globally.  Of these, in 2014, four were available in India, six in Brazil, eight in China, nine in Russia, and thirteen in Mexico.[4]  Cytotoxic agents were also difficult to access in 2014, with only two available in Brazil, China, Mexico and Russia, while Indian patients only had access to one.

For example, of the 27 targeted cancer drugs launched globally since 2009, only four were available in India last year, while Brazil patients had access to only six. Patients in China were able to obtain eight targeted drugs in 2014, while there was only nine available in Russia. Patients in Mexico fared the best, with access to 13 targeted medicines.  The availability of cytotoxic agents also was scarce in 2014 in Brazil, China, Mexico and Russia, where patients only had access to two of those products.  In India, however, there was only one of the new cytotoxic drugs available.[5]

Notably, the availability of targeted cancer drugs across these countries exactly mirrors the strength of intellectual property rights in these nations, as measured by the Global Intellectual Property Center.  The GIPCD index evaluates the intellectual property environment of a nation, across 30 indicators.  The index includes 30 nations which comprise close to 80% of the global economy (GDP).   The GIPC’s ranking is shown in Figure 1 below. 

Source:  Global Intellectual Property Center, 2015.[6]

As noted above, numerous factors influence whether a new drug is available in a particular market.  Nevertheless, it is important to recognize that the strength of a national intellectual property environment is a critical factor in determining a product’s launch speed in a particular country.  Lanjouw (2005) first showed that stronger IP protections, for both products and processes, correspond to faster launch times.[7]  Table 1, below, shows that this correlation continues to hold for available targeted cancer therapies.  

Source:  Data on the available targeted cancer therapies is taken from SCRIP Intelligence[8], and GIPC Score is taken from GIPC[9].

While strong intellectual property rights (IPRs) are frequently depicted as a barrier to wider access to medicines, evidence suggests that weak intellectual property rights environments are also a barrier to access, discouraging timely product launches. In the current debate over access to medicine, it is essential to recognize that insufficient IP rights also harm patients.  Affordable…unaffordable…before price can be an issue, products must be available.  As noted by Lanjouw, “Less than one-half of the new pharmaceutical molecules that are marketed worldwide are sold in any given country, and those that are sold are often available to consumers in one country only six or seven years after those in another.  Both price regulation and intellectual property rights influence these outcomes.” [10]  If cancer patients are to receive the treatments they need, nations must embrace both availability and affordability.  Sufficient intellectual property rights protection is key to availability. 


[1] Young, Donna.  “Cancer drug spending reaches $100bn; access varies widely,” SCRIP Intelligence, 5 May 2015.  Available at:   http://www.scripintelligence.com/home/Cancer-drug-spending-reaches-100bn...

[2] Young, Donna.  “Cancer drug spending reaches $100bn; access varies widely,” SCRIP Intelligence, 5 May 2015.  Available at:   http://www.scripintelligence.com/home/Cancer-drug-spending-reaches-100bn...

[3] Young, Donna.  “Cancer drug spending reaches $100bn; access varies widely,” SCRIP Intelligence, 5 May 2015.  Available at:   http://www.scripintelligence.com/home/Cancer-drug-spending-reaches-100bn...

[4] IMS Health. “Innovation in Cancer Care and Implications for Health Systems: Global Oncology Trend Report,” IMS Institute, 2015.  Available at:  http://www.imshealth.com/vgn-ext-templating/v/index.jsp?vgnextoid=f8d4df...

[5] Young, Donna.  “Cancer drug spending reaches $100bn; access varies widely,” SCRIP Intelligence, 5 May 2015.  Available at:   http://www.scripintelligence.com/home/Cancer-drug-spending-reaches-100bn...

[6] Global Intellectual Property Center (GIPC). “Unlimited Potential,” Third Edition, 4 February 2015.  Available at:  http://www.theglobalipcenter.com/wp-content/themes/gipc/map-index/assets...

[7] Lanjouw, Jean O. “Patents, Price Controls and Access to New Drugs: How Policy Affects Global Market Entry,” NBER working paper series, Working Paper 11321, May 2005.  Available at:  http://www.nber.org/papers/w11321

[8] Young, Donna.  “Cancer drug spending reaches $100bn; access varies widely,” SCRIP Intelligence, 5 May 2015.  Available at:   http://www.scripintelligence.com/home/Cancer-drug-spending-reaches-100bn...

[9] Global Intellectual Property Center (GIPC). “Unlimited Potential,” Third Edition, 4 February 2015.  Available at:  http://www.theglobalipcenter.com/wp-content/themes/gipc/map-index/assets...

[10] Lanjouw, Jean O. “Patents, Price Controls and Access to New Drugs: How Policy Affects Global Market Entry,” NBER working paper series, Working Paper 11321, May 2005.  Available at:  http://www.nber.org/papers/w11321

 

Tags

IP