The Business of Science: Patents and Public Health


Hi everyone!  I’m S, and I’m a studying biochemistry, which may explain the slight bias in my topic choices.  I’ve also had a love affair with public policy for the past several years, and enjoy discussing how science and policy intersect.  I regularly find myself pondering the disconnect between scientific research (i.e. drug discovery) and policy implementation (i.e. public health).  For my first post, I’ve adapted an editorial (which later turned into a research project, two presentations, etc.) about barriers posed by patents in the treatment of HIV/AIDS.

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In 1985, the Burroughs-Wellcome company (now GlaxoSmithKline) patented AZT, the first anti-retroviral medication used to treat HIV/AIDS. The discovery of AZT as an anti-retroviral was coincidental; it was originally synthesized to treat cancer, but failed.  Two years later, the drug was released under the trade name Retrovir, at a cost of almost $10,000 per year.  Burroughs-Wellcome was concerned about Retrovir’s potential for profit: at this point, only forty thousand people were diagnosed with HIV/AIDS.

In 2005, when the patent on AZT expired, there were over forty million HIV/AIDS patients, and few could afford the full price antiretroviral medications. The FDA quickly approved four generic versions of AZT, which sell for a fraction of the original cost.  Though AZT remains an important component in any HIV/AIDS treatment plan, it is no longer sufficient.

The HIV virus copies its genome often, introducing mutations that could render one medication irrelevant.  Physicians have begun prescribing three or four medications at a time, targeting multiple components in the viral replication cycle.  While this treatment has greatly increased the lifespan of an HIV diagnosis, it creates an expensive standard of care that cannot be fully distributed worldwide.

Pharmaceutical companies claim that the high costs of their products fund research and development to find more effective and cheaper medications. Patents theoretically protect this investment, while also eliminating innovation and competition by making such practices risky and expensive.  High prices for patented medications create an additional hurdle for aid organizations, and results in reduced access for thousands around the globe.

Lately, there has been a growing trend toward circumventing patents and increasing availability of essential medications.  Pharmaceutical companies have agreed to offer certain drugs at below-profit prices in developing countries.  Several European countries have created a Patent Pool, and the United States NIH has already contributed several HIV/AIDS drug patents for global use.  Yale University agreed to allow Aspen Pharmaceuticals to produce antiretroviral medications off-patent, creating competition in the market that led to a 96% price reduction of similar products.  As more patents expire and fewer are enforced, the future of HIV/AIDS treatment looks bright.

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A side note: one of my favorite books of all time is And the Band Played On.  It’s a fascinating history of the early AIDS epidemic.  The book is long (~600 pages), but definitely worth reading.

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