E-DRUG: GSK Access to Medicines: The Good, the Bad, the Illusory (2)
With respect to Professor Baker's excellent and well-reasoned message/analysis,
I wish to add my own feelings about making medicines available to those in need:
1. I applaud GSK for their efforts. They are well thought out and - to my best
observation - this is probably about the best a Big Pharma company can do for
emerging economies. And, it will possibly multiply the overall resources
available for drug discovery in neglected diseases. I worked for 10 years at
GSK and the people there were well meaning and their science is second-to-none.
2. But, we cannot ask Big Pharma to produce the huge range of modern medicines
for emerging markets. This does not fit their cost model (their production
costs are way too expensive) and it puts an unreasonable burden on companies
whose existence is to bring NEW medicines to the world.
3. Effective medicines exist for most of the diseases the put such crippling
burdens on emerging economies. There is a significant pool of money available
for their purchase (UNITAID, Global Fund, PEPFAR, and other donors). Access
must still become a reality at the same time that more effective medicines are
4. The generic companies of India, Brazil, China, Thailand and, increasingly,
Africa are among the areas where regional production is emerging. These
companies are important - their cost models provide us the least-expensive
access to Quality medicines - if we help them ensure QUALITY as well as price.
5. Big Pharma needs to support, or at least, not interfere with building
capacity for essential medicines production in areas where they are needed.
This is not a commercial loss for Big Pharma, these markets cannot support
innovator prices (even reduced ones) and these markets go beyond 50 countries.
Examples of Big Pharma reaching out for this purpose already exist. One such
is Lilly's technology transfer for cycloserine, both for API and finished dose
production. And these efforts are fantastic. But, even in India and China
the prices for drugs for malaria and TB are driving the generic providers out
of the market - costs do not justify the investment for scaleup and ensuring
In our near future, the singular problem of "CMC" (Chemistry, Manufacturing and
Controls) must be solved with education and capacity building in Africa,
Southeast Asia and South America in order to support putting finished medicines
on the shelf for those in need. This is going to take investment in areas
other than drug discovery and Clinical. Whoever produces medicines cannot LOSE
money in the process. Part of our overall effort in these areas is to enable
the lowest-possible production of high-quality essential medicines for all
purposes. The new realization takes into account that hypertension and many
other chronic diseases are important as well.
My thanks for the opportunity to send this message through e-drug.
Joseph M. Fortunak
Chemistry and Pharmaceutical Sciences
525 College Street NW
Washington, DC 20059 USA
+1 202 806 6880 (office)
+1 301 928 7568 (mobile)