INSTITUTE OF MEDICINE COMMITTEE ON THE U.S. COMMITMENT TO GLOBAL HEALTH

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INSTITUTE OF MEDICINE COMMITTEE ON THE U.S. COMMITMENT TO GLOBAL HEALTH Sharing Information, Knowledge and Materials Dr. Ashley J. Stevens Executive Director, Technology Transfer Senior Research Associate Institute for Technology Entrepreneurship and Commercialization School of Management Boston University

Agenda The Scale of the Problem Universities and Drug Discovery Licensing Approaches Issues

University Licensing Policies and Global Health Problem first surfaced in 2001 with Yale and Zerit d4t discovered by Drs. Tai-Shun Lin and William Prusoff Funded by NIH and Bristol-Myers Exclusively optioned then licensed to Bristol-Myers On list of Essential Medicines developed by Medécins Sans Frontieres Reuested waiver of S. African patent Initially rejected by BMS Yale powerless Story in NY Times BMS agreed not to assert S. African patent

Universities and Drug Discovery

The Contribution of Public Sector Research to the Discovery of New Drugs Jonathan J. Jensen, [1], Katrine Wyller, [2], Eric R. London, [3] Sabarni K. Chatterjee, [5] Fiona E. Murray, [4] Mark L. Rohrbaugh, [5] and Ashley J. Stevens [6], [1] Office of Technology Transfer, Boston University, Boston MA, Contributed eually to this study, [2] Norwegian Radium Hospital Research Foundation, Oslo, Norway, [3] Robert Wood Johnson Foundation, Princeton, NJ, [4] Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA [5] National Institutes of Health, Washington, D.C., [6] Office of Technology Transfer and Institute for Technology Entrepreneurship and Commercialization, Boston University, Boston, MA Corresponding Author; astevens@ bu.edu

4/8/2009 FDA Approved Products Discovered at Public Sector Research Institutes Type of Product Number New Chemical Entity 90 Biologic 30 Vaccine 16 Over the counter 1 In-vivo diagnostic 8 Total 145 6

4/8/2009 Therapeutic Category Therapeutic Area Number Oncology 37 Infectious Disease 36 Cardiology 12 Metabolic 12 CNS 10 Dermatology 7 Renal 7 Ophthalmology 6 Gastroenterology 4 Immunology 4 Women's Health 3 Allergy 2 Pulmonary 2 Anaesthesiology 1 Dental 1 Urology 1 Total 145 7

Let s think about how we get a public sector discovered drug to the global market

The Traditional Academic Development Model

How do we modify this process to achieve affordability?

Include Developing Country Milestone and Pricing Licensee shall seek registration in a developing country by. Licensee shall make available in developing countries at prices no more than 50% more than fully burdened manufacturing cost

Don t Allow Patenting in Developing Countries X

Separate Licensees

Mandatory Sublicensing

Non-Assert X

The Issues Academic technologies are embryonic, high risk and uncertain A hot academic technology is one that two companies are interested in First do no harm Where is the motivation for Universities to include global health protections? Makes the negotiation more difficult Potential show stopper Reduces income (maybe) Rarely any incentive compensation to motivate Licensing Managers Part of academic social mission Culture of academic licensing Power lies with corporate licensees Gilead, Glaxo, J&J in leadership position on voluntary licensing What licensing approaches will be acceptable to corporations?

AUTM 2007 Licensing Activity Survey Invention Disclosures 19,827 New US Patent Applications filed 11,797 59.5% US Patents Issued 3,622 18.3% Licenses Signed 4,391 22.1% Start-Ups formed 555 2.8% Active Licenses 30,351

Financial Performance Financial Contribution Number % Loss making 68 52.3% Gross profitable 27 20.8% Net profitable 14 10.8% Self sustaining 21 16.2% Total 130

The Issues AUTM leadership totally committed Establishing a task force UNITAID, UAEM, Gilead attended 2009 Annual Meeting Need a forum to discuss and develop a consensus policy e.g., Global health protections will be included whenever healthcare products are licensed Over 50% of Orange Book listings include patents held by others What is the role of the emerging patent pools? UNITAID Could universities issue global health licenses to the pool? cf Government Rights license Then grant Exclusive but for to the primary developer What if the pool license is a deal breaker? First do no harm

4/8/2009 Boston University Adopted global health licensing principles in October 2007 Process underway to make it a University policy Non-assert approach Limited to public sector programs Four licenses completed to date All faculty start-ups One preferred an alternative approach to non-assert First one approaching a big pharma partnership Including global health protections in: Therapeutics and prophylactics Diagnostics Not including in: Tools Devices 21

4/8/2009 Questions? astevens@bu.edu 22

A New Pharmaceutical Business Paradigm

The Traditional Pharmaceutical Paradigm Price NDA Submission ANDA Submission NDA Approval ANDA Approvals Year 0 10 20

The New Pharmaceutical Paradigm NDA Submission NDA Approval Year 0 10 20 ANDA Approvals

We could try to change the patent system to achieve this Or we could change the licensing system The problem isn t the patent system Patents just give you control over what happens to your IP An essential component of the innovation system We should be very cautious about changing it It s much easier (and less risky!) to change licensing behavior E.g. PCT Treaty signed 1970 Came into effect in 1978

Licensing Mechanisms (a) Voluntary Contractually reuiring availability in developing countries Reuiring the licensee to include developmental milestones; Contractually reuiring availability and affordability in developing countries without specifying the way this will be obtained Reuire the licensee to develop the product in developing countries and to sell it using cost+ pricing; Specifying desired outcomes of availability and affordability in developing countries and including an enforcement mechanism to achieve competition if the specified outcomes do not occur Reserving a march-in right to grant additional licenses to be exercised if the product is not made available in developing countries in a timely manner or if prices in developing countries are too high;

Licensing Mechanisms (b) Forced Competition Specifying mechanisms to achieve competition Excluding developing countries from the license and issuing nonexclusive licensees in developing countries separately Granting only non-exclusive rights in developing countries Reuiring the licensee not to patent in developing countries Reuiring the licensee to grant sublicenses in developing countries at low or zero royalty rates Reuiring the licensee to commit to not assert the licensed IP in developing countries