Expensive medicines are a growing problem the world over and for too long big pharma has been able to charge extortionate prices, leaving patients struggling to access the treatment they need. The plight of Luis Walker, the 9-year old boy with cystic fibrosis featured in Jeremy Corbyn’s speech at the Labour party conference yesterday, illustrates how fundamentally broken our system of developing medicines is and why proposals to protect public health and take on the power of pharmaceutical companies are so desperately needed.
The drug, Orkambi, can not only alleviate the symptoms of cystic fibrosis but could actually slow the progression of the disease, potentially adding years of life to patients like Luis. But this drug is not available on the NHS in England because it is too expensive. Despite three years of negotiations, drug company Vertex is still refusing to lower its hefty price tag of £105,000. Keeping the price of Orkambi this high is no anomaly. Patent monopolies over new drugs means that no other company can make or sell that drug for up to 20 years and companies like Vertex are able to hike up their prices as a result.
From breast cancer to Hepatitis C medicines, the system is designed to increase profits for big pharma at the expense of patient access. But the legal tools to break this deadlock exist and have always been in the hands of governments. Labour’s announcement to use them shows they are willing to take on the powerful pharmaceutical lobby on behalf of patients.
A compulsory license, enshrined in World Trade Organisation rules is a legal right which enables a government to override a patent in the public interest by allowing other companies to produce generic versions of the drugs at lower prices. It was used to procure medicines in the UK in the 1960s and 1970s and has been used effectively in over 100 countries since 2001 including the US, Germany and Malaysia. It's a legal right intended for governments to use to protect public health in exactly the sort of situation that patients are facing with Orkambi.
We need to move away from the profit-driven model where decisions are based purely on the areas of greatest financial returns rather than the greatest public health needs. The failure of this model is most acute in the area of developing new antibiotics. In spite of the impending antimicrobial resistance crisis, there has been insufficient investment into antibiotics as they are not deemed profitable by an industry that directs innovation only towards profitable areas. There has also been insufficient investment into conditions that affect people living in the global south, again because these markets are considered not lucrative enough. This model does not treat health as a human right and is not delivering the health innovation that we need.
Labour’s commitment goes beyond willingness to use compulsory licenses which will help with high prices in the short term. They have also committed to transforming the whole innovation system and tackling the fundamental problems head-on.
Publicly-funded breakthroughs get licensed to private companies, which then set high prices and extract excessive profits. The public pay twice, first for the research and then in high prices. In the last two years, the NHS spent £2 billion on drugs where public money had funded their research and development. To ensure public return on public investment and that medicines are affordable and accessible to all, Labour announced that conditions should be attached to drugs developed with publicly-funded research. Protecting patients and public institutions like the NHS is exactly the direction other political parties should follow.
And Labour is also supportive of developing public drug development and manufacturing capabilities. The pharmaceutical industry already benefits from substantial public investment and is an industry of strategic importance for public health. Labour’s commitment to public ownership could enable future governments to fulfil its obligations to ensure the right to health by taking on parts of the manufacturing and distribution process to supply affordable medicines to the NHS.
The crisis in patient access and spiraling prices means doing nothing is not an option. Instead, we need political commitment to re-orientate the whole system. We need more public control to ensure health innovation meets public health needs and drugs are affordable and accessible to the people who need them. The firm commitment of the Labour party to undertake a series of reforms that will transform the health innovation system is welcome news - especially for all who struggle to access the medicines they need.