[Ip-health] HIF proposes $600 million annual budget to evaluate health impacts

Wed Dec 3 13:01:15 2008

I thank all the ip-health contributors for their suggestions and comments. =
I
have been on the road and unable to respond with the attention needed. But
we have been listening and I hope learning and will be commenting fully on
the issue of prices and how they could be determined in the HIF.

However, Mickey Davis has made some claims which should be corrected
immediately. First, Incentives for Global Health receives no funding from
the pharmaceutical industry. Second, I worked for the Competition Bureau in
2003-4. The Bureau is the Canadian competition authority and is under the
umbrella of Industry Canada, a department of the federal government. It is
not the Chamber of Commerce of anywhere, but a government department, and
obviously bears no responsibility for anything I write.

Following recent revelations in Canada, Mickey is of course free to make
disparaging comments about the honesty of politicians as well.

Aidan Hollis

Associate Professor
Department of Economics, University of Calgary
2500 University Dr NW Calgary AB T2N 1N4 Canada

tel: +1 403 220 5861  fax: +1 403 220 5861
email: ahollis@ucalgary.ca
web: http://econ.ucalgary.ca/profiles/aidan-michael-hollis

Incentives for Global Health
http://www.healthimpactfund.org
----- Original Message -----
From: <michael.davis@law.csuohio.edu>
To: <malini.aisola@keionline.org>
Cc: "ip-health" <ip-health@lists.essential.org>
Sent: Wednesday, December 03, 2008 7:40 AM
Subject: Re: [Ip-health] HIF proposes $600 million annual budget to evaluat=
e
health impacts

That is not surprising. The institute which sponsored the project is
industry-funded. At least one of the researchers is on the payroll of
Industry Canada which is simply the Chamber of Commerce there.

What is worse (?) is that the money is to be used, at least in part, to
process data supplied by the pharmaceutical industry itself, data upon
which the entire project relies. After Enron, World.com, AIG, and
everything else, I find it surprising that people are still willing trust
industry to be honest about anything, even under penalties of perjury.

Mickey Davis

> HIF proposes $600 million annual budget to evaluate health impacts
>
> http://www.keionline.org/blogs/2008/12/03/600mill-2-evaluate-impacts/
>
> One feature of the HIF that is raising eyebrows is their proposal to
> spend $600 million *per year* on assessing health impacts. This is
> apparently more than an order of magnitude greater than the entire
> budget of NICE.  The reference to the $600 million from the HIF book
> follows:
>
> <begin quote>
>
> Aidan Hollis and Thomas Pogge, The Health Impact Fund, Making New
> Medicines Accessible for All, A Report of Incentives for Global Health,
> 2008
>
> Page 30-32
>
> THE COST OF HEALTH IMPACT ASSESSMENT
>
> Health impact assessment would be expensive, given the need to assess a
> variety of medicines globally. There would, of course, be some economies
> of scale from assessing many medicines at the same time, and
> efficiencies from assessing the same medicine year after year. However,
> a reasonable perspective is that if the HIF had an annual budget of $6
> billion, it could spend about $600 million on administration and
> assessment, with the bulk being devoted to assessment. This would make
> it by far the largest health assessment agency in the world. For
> comparison=E2?Ts sake, NICE (the UK=E2?Ts National Institute for Clinical
> Excellence) has a budget of approximately $50 million. NICE publishes
> around 25 technology appraisals, 12 clinical guidelines and 60 pieces of
> interventional procedures guidance each year (NICE 2004). The HIF would
> have, assuming a stock of about 20 medicines registered at any time, a
> requirement to evaluate the impact of those medicines around the world,
> which would be a much more difficult process than that undertaken by
> NICE. However, there could be considerable external benefits from such
> an assessment process, including primarily that it would enable better
> prescribing as the relative therapeutic benefits of different products
> were better understood.
>
> The HIF would be by far the largest health assessment agency in the
> world.
>
> A budget of $600 million, spent on roughly 20 medicines at any given
> time, yields an average budget per year per drug of $30 million. How
> would this be spent? Part would be allocated to evaluating clinical
> evidence. Current estimates of the cost of trials can be found in Holve
> and Pittman (2008), who estimate that head-to-head studies range in
> price from approximately $2.5 million for relatively small studies to
> $20 million for large studies. Such studies, of course, would not be
> conducted every year; some such studies could be performed by the
> registrants, though the HIF could also commission its own independent
> studies where needed. Observational studies range in cost from $1.5
> million to $4 million. The HIF would require observational studies in
> different settings, though not every year, so this could be quite
> costly. However, it is likely that observational studies would be less
> expensive in developing countries. Systematic reviews of evidence tend
> to cost up to around $0.3 million. The HIF would also require a
> substantial auditing function to ensure that the products were being
> distributed and used in ways consistent with the findings of the
> observational studies. Finally, there would be a significant overhead
> component related to obtaining the functions of the technical branch and
> other operational branches, which could be shared across products.
>
> Errors using inadequate data are much less than those using no data at
> all.
>
> <end quote>
>
> --
> Malini Aisola
> Knowledge Ecology International
> 1621 Connecticut Avenue NW, Suite 500, Washington DC 20009
> Tel: +1.202.332.2670 Fax: +1.202.332.2673
>
> _______________________________________________
> Ip-health mailing list
> Ip-health@lists.essential.org
> http://lists.essential.org/mailman/listinfo/ip-health
>

--
Mickey Davis
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Cleveland State Univ. College of Law
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