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

Wed Dec 3 13:37:11 2008

Aidan's correction requires some amplification and correction of its own.

I never wrote that IGH receives "funding from the pharmaceutical
industry." I wrote quite clearly and literally that it is "industry
funded." As far as I have been able to discover, it has two major sources
of funding, the BUPA foundation and a branch of the Australian government
devoted to industry and innovation, which is devoted to the patent
industry. BUPA does not reveal who it gets its money from, and, in a way,
neither does the Australian patent industry, but that, I think, is the
problem.

As to Industry Canada, Aidan is right, it is not the Chamber of Commerce.
It is worse. It is the Canadian Patent Office--or more accurately, the
Canadian Patent Office (or more correctly the Canadian Intellectual
Property Office) is part of Industry Canada.

> 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. Bu=
t
> we have been listening and I hope learning and will be commenting fully o=
n
> 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 i=
s
> 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
> evaluate
> 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 Clinica=
l
>> 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
>>
>> _______________________________________________
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>>
>
>
> --
> Mickey Davis
> _________________________________
> Prof. Michael H. Davis
> Professor of Law
> Cleveland State Univ. College of Law
> 1801 Euclid Ave.
> Cleveland, OH 44115-2214
> (mailing address: 2121 Euclid Ave. LB 234)
> 216-687-2228
> _____________________________________________________________
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>
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--
Mickey Davis
_________________________________
Prof. Michael H. Davis
Professor of Law
Cleveland State Univ. College of Law
1801 Euclid Ave.
Cleveland, OH 44115-2214
(mailing address: 2121 Euclid Ave. LB 234)
216-687-2228
_____________________________________________________________
Patent Attorney Admitted to Practice Before the US Patent and Trademark
Office Reg.No. 45,863

Peace, Love, and Vegetable Rights!
Eat Meat and Save the Plants!