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Strong Medicine:
Creating Incentives for Pharmaceutical Research on Neglected Diseases
Michael Kremer & Rachel Glennerster

Book Description | Reviews
Introduction [HTML] or [PDF format]

TABLE OF CONTENTS:

Foreword ix
Acknowledgments xiii
1. INTRODUCTION 1
2. HEALTH IN LOW-INCOME COUNTRIES 6
The Disease Environment in Low-Income Countries 6
Weak Health-Care Infrastructure 7
Malaria, Tuberculosis, and HIV/AIDS 11
The Impact of Cheap, Simple Technologies 20
3. THE PAUCITY OF PRIVATE R&D TARGETED TO THE NEEDS OF LOW-INCOME COUNTRIES 25
The Extent of R&D Targeted to Low-Income Countries 25
The Scientific Potential for New Vaccines 27
4. MARKET AND GOVERNMENT FAILURES 29
Why Target Foreign Assistance to Vaccine R&D? 30
The Patent Tradeoff 33
Low-Income Countries and Intellectual Property 36
Social versus Private Return: Some Quantitative Estimates 40
The Role of Public Purchases 42
5. THE ROLE OF PUSH PROGRAMS 45
Meningococcal Meningitis: An Example of a Successful Push Program 46
A Cautionary Tale: The USAID Malaria Vaccine Program 47
Incentives under Push Programs 49
6. THE POTENTIAL ROLE OF PULL PROGRAMS 55
The Effect of Market Size on Innovation 55
The Impact of Financial Incentive Programs 56
Examples of Pull Programs Stimulating Research 59
Advantages and Limitations of Pull Programs 63
7. PULL PROGRAMS: A MENU 68
Commitments to Finance Purchase of Products and Patents 68
Patent Extensions on Other Pharmaceuticals as Compensation for Vaccine Development 70
Best-Entry Tournaments 72
Expanding the Market for Existing Vaccines and Drugs 73
8. DETERMINING ELIGIBILITY 76
Basic Technical Requirements 76
Independent Adjudication Committee 78
Market-Test Requirement 81
Exit Clauses 84
9. HOW MUCH SHOULD WE PROMISE TO PAY FOR A VACCINE? 86
What Market Size Is Needed to Spur Research? 86
Cost-Effectiveness: What Is a Vaccine Worth? 90
10. HOW SHOULD PAYMENT BE STRUCTURED? 97
Paying for Multiple Vaccines and Market Exclusivity 100
Bonus Payments Based on Product Quality 103
Increasing the Promised Price over Time 105
Avoiding Windfalls 106
Industry Consultations 107
11. SCOPE OF THE COMMITMENT 109
What Diseases to Cover? 109
Vaccines, Drugs, and Other Technologies 109
Incentives for Agricultural R&D 112
12. MOVING FORWARD WITH VACCINE COMMITMENTS 115
Making a Commitment Legally Binding 116
The Politics of Creating Markets for Vaccines and Drugs 118
Potential Sponsors of New Markets for Vaccines and Drugs 119
References 127
Index 145

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File created: 7/11/2014

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