Does The Commercialisation Of Medicine Lead To Medical Innovation?

The biomedical researcher Michael Kinch, who in 2013 reviewed all new molecular entities (NMEs, drugs) approved by the U.S Food and Drug Administration (FDA) since its inception, argues that the world is facing a significant crisis in its capability to develop new drugs and deliver medical innovation exactly when these are needed most[1]. Kinch argues that the rise of antibiotic resistance is the ‘canary in the coalmine’ for this crisis[2] for example, at the same time as over 60% of Staphyloccocal infections in hospital are caused by the antibiotic-resistant ‘superbug’ MRSA (as of 2003)[3], as of 2000 it took 30 years to introduce a new class of antibiotics[4].

Moreover, medical innovation is also needed to help tackle the current global COVID-19 pandemic, as well as in treatment of cancer and a host of incurable rare diseases. This dissertation aims to evaluate whether the commercialisation of medicine helps or hinders this process, and its responsibility for the potential crisis described by Kinch. In particular, I will focus on the development of drugs in the U.S and the UK, which combined are the headquarters of eight of the 10 biggest pharmaceutical companies in the world[5] [6], and are generally regarded as world leaders in medical research.

Definitions

This paper defines commercialisation as a combination of the aspects of ‘marketisation’ and ‘privatisation’, which in turn are as defined by the authors Nick Krachler and Ian Greer.

‘Marketisation’ is essentially an exchange of goods (in this case, medicines and medical devices) through price-based competition, or the intensification of it[1] [2].

‘Privatisation’ is defined as a transition to provision, manufacturing, or research being managed by non-state entities [3](i.e. pharmaceutical and biotechnology companies).

‘Innovation’ is more difficult to concretely define, but this dissertation uses the Collins Dictionary definition, which defines it as introducing new ideas, methods or things [4](in this case, new drugs and treatments).

Sources and commentators in the field mostly discuss three main factors relating to commercialisation of medicine and medical innovation: profitability and pursuit of profit, research funding and process, and patents.

Discussion

The main arguments in favour of commercialisation of medicine leading to medical innovation can be summarised as: the research funding provided by pharmaceutical companies is invaluable to medical innovation the competition within the industry is paramount in fostering innovation and because pharmaceutical companies aim to maximise profitability, financial incentives easily enhance the innovative effect of the pharmaceutical industry.

On the other hand, the main arguments against the commercialisation of medicine leading to medical innovation relate to: monopolies and patents, since this stifles competition and innovation public funding, as this removes the credibility of simply commercialised medicine leading to innovation and risk, or more accurately the avoidance of risk by pharmaceutical companies which arguably hinders medical innovation.

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What do you think? Does the ‘commercialisation of medicine’ – that is, the actions of the pharmaceutical industry – help or hinder medical innovation?

[1] Kinch, A prescri ption for change: the looming crisis in drug development., 206-226

[2] Drahos and Braithwaite, Information feudalism: Who owns the knowledge economy?, 6, Healy, Pharmageddon., 27-30

[3] Kinch, A prescri ption for change: the looming crisis in drug development., 223-224, 230, Casper and Matraves, "Institutional frameworks and innovation in the German and UK pharmaceutical industry."

[4] Kinch, A prescri ption for change: the looming crisis in drug development., 57-60, Sköld, Antibiotics and antibiotic resistance., 6-8, Healy, Pharmageddon., 39

[5] Wellman-Labadie and Zhou, "The US Orphan Drug Act: rare disease research stimulator or commercial opportunity?.", Casper and Matraves, "Institutional frameworks and innovation in the German and UK pharmaceutical industry.", Kinch, A prescri ption for change: the looming crisis in drug development., 178

[6] "The quest for a vaccine could restore faith in big pharma."

[1] "When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act - ScienceDirect," (Article), Social Sciences Medicine, 2015, accessed 07/03, 2020, https://www.sciencedirect.com/science/article/abs/pii/S0277953614007771.

[2] "Marketisation," Collins Dictionary, 2020, accessed 10/03/20, 2020, https://www.collinsdictionary.com/dictionary/english/marketisation (Definition of marketisation, with examples).

[3] "When does marketisation lead to privatisation?.",215-223

[4] "Innovation," HarperCollins, accessed 10/03/20, 2020, https://www.collinsdictionary.com/dictionary/english/innovation (Definition of innovation).

[1] Michael Kinch, A prescri ption for change: the looming crisis in drug development (UNC Press Books, 2016)., p.g 9-11

[2] Kinch, A prescri ption for change: the looming crisis in drug development., 11-12

[3] Roxanne Nelson, "Antibiotic development pipeline runs dry," The Lancet 362, no. 9397 (2003), The Lancet.

[4] Ola Sköld, Antibiotics and antibiotic resistance (Wiley Online Library, 2011)., 193

[5] "U.S Pharmaceutical Industry - Statistics Facts," Statista, 2017, accessed 19/05/20, 2020, https://www.statista.com/topics/1719/pharmaceutical-industry/ (Statistics and facts about the U.S pharmaceutical industry).

"Pharmaceutical industry in the United Kingdom (UK—Statistics Facts," (Fact page), Statista, 2019, accessed 19/05/20, 2020, https://www.statista.com/topics/5056/pharmaceutical-industry-in-the-UK/ (Statistics about pharmaceutical industry in the UK).