The world is facing an access to medicines crisis, and Europe is no exception.
Over-priced lifesaving medicines are being rationed in high-income countries due to the increased financial stress on healthcare systems. Whether it’s new drugs for the treatment of hepatitis C, cancer or cystic fibrosis, people across Europe are struggling to access the medicines they need because of increasingly high prices. As the next European Commission is set up following the upcoming European elections, the international medical humanitarian organisation Médecins Sans Frontières (MSF) calls for the development of sustainable pharmaceutical research and development (R&D) policies in Europe that ensure affordable access to medicines for all Europeans and beyond.
Why are drugs so expensive?
The astronomical price of many essential medicines stems primarily from patent monopolies held by pharmaceutical corporations and a lack of price-lowering competition. High drug prices have long restricted access to affordable and lifesaving treatment needed by millions of people in developing countries. MSF witnessed first-hand how generic competition lowered the price of antiretrovirals for the treatment of HIV/AIDS from more than US$10,000 per patient per year in 2000 to less than $100 today. These dramatic price reductions have made it possible to provide HIV treatment to over 22 million people globally.
Since its market approval in 2014, sofosbuvir, a new drug to treat hepatitis C, continues to be rationed by several European governments due to its high price of €20,000 per treatment course. MSF procures the same drug at €75 per treatment course from generic manufacturers. The extreme range in prices charged for this essential medicine by different manufacturers reflects the arbitrary nature of price setting by pharmaceutical corporations, with no rationale other than profit-maximisation made possible by abuse of the patent system.
It’s commonly argued that granting patents and other forms of exclusivity rights to pharmaceutical corporations is necessary to promote R&D for new medical tools. But developing medicines under a monopoly-based model comes at a high social cost: exorbitant drug prices undermine affordable healthcare thereby eroding the right and access to healthcare for people in Europe and around the world. Moreover, the current system has failed to stimulate real innovation that answers to priority health needs. Drugs that are deemed less economically profitable—such as antibiotics, medicines for Ebola or antidotes for snakebites—lack investment by the pharmaceutical industry, despite killing hundreds of thousands of people in developing countries.
The public and philanthropic sectors contribute substantially to the R&D of medicines through grants, tax credits and in-kind contributions by research institutes, treatment providers and patients involved in clinical and operational research. Nevertheless, medicines, often developed through multi-sectoral partnerships, continue to be “owned” exclusively by the monopoly-holding pharmaceutical corporation and remain unaffordable and inaccessible for many. For instance, Lutetium-octreotate, a medicine for neuroendocrine tumours largely developed by a public hospital in the Netherlands, became unaffordable to Dutch patients earlier this year after pharmaceutical corporation Novartis obtained exclusive rights to the drug and increased its price five-fold to €92,000 per treatment course.
Demonstrating that R&D can be done differently, MSF, along with five other public health research institutes, co-founded the non-profit Drugs for Neglected Diseases initiative (DNDi). Under DNDi’s collaborative model, all of the costs for R&D are paid by public and philanthropic donors—including sometimes in-kind contributions from the pharmaceutical industry—and are managed according to its principles. This allows the organisation to identify its priorities based on public health needs and offer products at sustainably low prices. It recently launched an all oral treatment for sleeping sickness, a fatal neglected disease endemic to Africa, that has long been ignored by pharmaceutical corporations.
The sky-rocketing price of medicines has provoked public outcry in Europe, prompting positive political developments. In 2016, the European Council raised concerns about exorbitantly high drug prices. It subsequently called on the European Commission to conduct an evidence-based analysis of the function and impact of intellectual property incentives on access to medicines in Europe. The Commission needs to step up and take concrete actions to address the abusive practice of excessive pricing.
European citizens will elect a new parliament in May, and a new European Commission will be set up. Now is the right moment for governments in Europe to demonstrate political will and task the next European Commission to develop and promote more adapted ways to support R&D and advance innovation while ensuring access to affordable medicines that people need.
Medicines are not developed in a vacuum. They are the result of a massive collective effort by public, philanthropic and private entities including researchers, funders, doctors and patients that should not be seized by pharmaceutical corporations for profit maximisation. Cultivating fair collaboration among all stakeholders should be at the centre of any European policy promoting R&D.
It’s time to prioritise people’s health over the pharmaceutical industry’s excessive profits.
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