Tag Archives: “bad idea”

Greedy governments, poorer societies

Beggar in Venis, May 2008

Government greed at work

Greedy governments stifle innovation by reserving all the intellectual property of publicly funded research for their own use.  The problem is that governments are not very good at knowing what to do next, and invariably tie up valuable innovation in bureaucratic process, without adding any social value at all.

The Eurocrats like US comparisons, so here is a good one.  In 1945, the US Government commissioned Vanevar Bush to review the role of science in post-war America.  His report founded the US National Science Foundation.  It was, however, not until US scientific pre-eminence in patents began to flag when compared to Japan and others, that US legislators realised that they were hogging all the innovation.  The result, the Bayh-Dole Act (the University and Small Business Patent Procedures Act) in 1980 gave US universities and businesses ownership of the discoveries resulting from US government-funded research.  The result is what we have today, and why the EU compares unfavourably.

The whole EU labours under mistaken beliefs about the central role of government in adding value.  In this case, getting the dead hand of the state off the bright ideas of the research community galvanised the US academic and commercial communities into entrepreneurial development which continues to this day.

Some EU members are very good at converting research into commercial products, have vibrant venture capitalists who are knowledgeable in finding winners, coupled with entrepreneurial research communities.  Others, of course, are laggards, or worse, deadwood.  The Biopolis report is a useful map of the terrain in one area.  Sitting at the heart of the issue, though, is the academic culture itself which in many countries lacks an entrepreneurial dimension, with inappropriate incentives and featherbedding of senior academics.  Perhaps the greatest threat to innovation besides greedy governments, is academic tenure.

The race these days goes to the smartest.  Let’s hope the Commission’s Communication on Pre-commercial Procurement will actually drive innovation.

Innovative medicines: it is about the patient, stupid!

The Clown

Clowning around with policy

The Innovative Medicines Initiative seeks to put right the chaotic treatment of pharmaceutical innovation by EU member states, and will likely fail.  The goose that lays golden eggs of medical innovation is cooked to death by member state medicines policies.

Increasing the speed of product development will come to a grinding halt as member states inconsistently apply economic evidence, and thereby stifle adoption of new medicines into clinical use to the benefit of patients.

Current regulatory thinking (i.e. EMEA) is dated as the priorities have moved beyond safety/efficacy issues to outcomes and cost-effectiveness.   NICE and its counterparts across Europe have yet to harmonise their methods, adding uncertainty as member states use economic evaluation as a 4th hurdle which varies in height depending on which country you’re in.  That economic evaluation is really just a code for controlling health expenditure and reimbursement, and is less about real value and outcomes in many member states only adds to chaos of the regulatory environment into which innovative products are thrown.

So, as we incentivise the early stages of medicines development and speed up the launch of drugs, we continue to tolerate a bottleneck on the utilisation and adoption of medicines themselves within member states.    The whole translational medicine process, from bench to bedside, is not just of faster benches, but of clear bedside clinical priorities.  We can incentivise the bench until the cows come home, but until we address the real disconnect between adoption and utilisation and link innovation priorities with real-world priorities, patients will still not have the medicines they need.  However, the statistics will undoubtedly show a rise in innovation!

Canada’s dairy supply management system is a public health menace

Espace Opéra Milk
Hard to believe, but this is a symbol of politics in Canada: free-traders beware!

The supply management system inflates the cost of diary products to Canadian consumers. Canada also applies substantial duties on imported dairy products. Both of these practices are of dubious benefit to consumers, and cost them substantial sums of money each year. It also has public health consequences that have been ignored.

In other countries, and particularly within the European Union, prices for milk, cheese, probiotics, yoghurt, etc. are about 30-40% of Canadian prices. By comparison, in a typical Canadian grocery store, a litre of low fat milk ranges between C$2.14 and C$2.40, three times the price in Europe.

There is some evidence that high prices may discourage parents from buying milk for their children. This may correlate with family income relative to poverty thresholds. Research has quantified how children substitute sugary carbonated drinks for milk. Reduced dairy consumption may be contributing to rising obesity in children and perhaps rising incidence of Type II diabetes, something we thought only showed up much later in life.

Milk consumption is also lower for girls, which may predispose them to osteoporosis later in life. Recent Canadian research has shown that reduced milk consumption during pregnancy leads to low birth-weight babies. We are also seeing the return of rickets.

At present, the parties to the supply management system itself are the main sources of information for consumers on dairy products. This makes it virtually impossible for consumers to access independent information. This is a tight circle that may not be acting in the public interest when looked at in terms of implications to human health.

The logic of the dairy supply management system is weak when tested against public health outcomes.  It is time to abandon this policy, which favours the few, has public health consequences for the many, and adds costs to provincial healthcare systems already under significant stress.

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