Medicines360 and the Rise of Non-Profit Pharmaceuticals

| January 15, 2013 | 0 Comments
Image credit: Maryland Department of Health and Mental Hygiene.

Image credit: Maryland Department of Health and Mental Hygiene.

Reproductive health is becoming an increasingly important concern in developing countries, where it represents the confluence of three essential issues: women’s rights, health, and economics. Increasing the availability of contraceptives can address all three of these issues, yet pharmaceutical companies are often reluctant to pursue these projects because the available profit margin is small. A new, innovative cancer drug can be priced at thousands of dollars a dose, but a new hormonal contraceptive must be made much more affordable to be a viable business venture.

But effective solutions to this and other global health problems need not be reliant on large pharmaceutical companies that garner billions of dollars of profit. New non-profit and hybrid-model pharmaceuticals, for instance, are now being formed to address specific niches that larger investor-based pharmaceuticals may neglect. The non-profit OneWorld Health was founded in 2000 to address neglected infectious diseases in developing countries, such as leishmaniasis and helminthiasis, as well as cholera and malaria.

This model allows non-profit pharmaceutical companies to collaborate with major pharmaceuticals that possess the scientific manpower to develop drugs that the for-profit industry ignores. For instance, today’s major pharmaceutical companies often invest in me-toos, slightly altered versions of existing drugs that have a guaranteed market. While these become highly profitable, they have marginal utility, because they reach an audience that already has other options. In contrast, product development partnerships (PDPs) between non-profit and for-profit pharmaceutical companies focus on developing abandoned orphan drugs. These may have been deemed potentially efficacious by the major pharmaceutical company, but would serve only small or poor populations for which potential returns would not recoup investment costs. PDPs would thus allow the development of more needed drugs at limited cost to the for-profit pharmaceutical company and great benefit to the target populations [1].

However, OneWorld Health founder Victoria Hale saw an opportunity to build on a new model that would create even greater independence from for-profit pharmaceuticals, and went on to found the hybrid-model Medicines360, focusing on often-neglected women’s health. Unlike OneWorld Health, Medicines360 will run on a unique hybrid funding model. Hale explained in an interview with the HCGHR, “We will have a commercial sector price, which will move through the United States through the traditional marketing pathway… and we will provide the same product, sold at a significantly reduced price, to the public sector, to women who are uninsured, or to other programs” [2]. Because the profits generated by the for-profit arm in the United States will be used to fund the global health efforts of the non-profit arm, this hybrid model should be self-sufficient, and will ideally divorce the company from the need to secure investor funding.

Medicines360’s first project is an intra-uterine device (IUD) that is still undergoing clinical trials. Because they only need to be inserted once to provide years of benefit, IUDs have long been considered an inexpensive, reliable, long-term alternative to other forms of contraception such as condoms [3]. According to Hale, IUDs thus have particular appeal to applications in global health, where such a device would place the reproductive choice in hands of women, who would then be “set for several years with this product” [4].

Though IUDs are currently a popular form of contraception in Asia, they do present some disadvantages that companies like Medicines360 will have to overcome in order to make IUDs widely accepted in new markets, like Africa. For one, the complications resulting from a misplaced IUD are serious, and can lead to dangerous pelvic inflammatory disease [5], as well as painful IUD withdrawal. There has also been some evidence that hormone-releasing IUDs are linked with a higher risk of HIV transmission, an issue particularly challenging in sub-Saharan Africa, where HIV is increasingly prevalent [6].

In addition, the time and skill needed to provide a woman with an IUD is much greater than those needed to provide a man with a condom [7]. Hale acknowledged that insertion would require a healthcare provider who was trained, but also noted that “[one would] just have to touch that infrastructure one time, and then you have five, seven, ten years of contraception.” One solution is to equip medical camps that travel to the women to offer contraception, much in the same way that camps currently travel to deliver vaccines and medicines for tropical diseases. “That infrastructure can reach parts of the world by coming to the world itself, instead of waiting for women to travel to cities,” Hale stated [8].

Although non-profit and hybrid- model pharmaceuticals have been working to increase their independence from third parties, the reliance on existing infrastructure for distribution is one of several gaps in the model that is not fully resolved. Non-profits are still developing a long-term secure funding model, which the hybrid-model attempts to address, so that they can become less reliant on grants from global health initiatives such as the Gates Foundation. In addition, the sheer cost of drug development from clinical trials through distribution represents a high entry barrier to the market.

Hale is hopeful, though, stating that she believes the hybrid-model for pharmaceuticals is a “great opportunity.” She highlighted that finding the “growing market,” driving demand for that market, and innovating to meet the needs of that market, will be key to the success of Medicines360 and companies like it [9]. Only then can new funding methods hope to impact not only the biomedical market but also the social aspects of global health.


Sources:

  1. Kondro, Wayne. “”The Best or the Worst” End up in Product Development Partnerships.” Canadian Medical Association Journal 182.17 (2010): E761-762. Print.
  2. “Interview with Victoria Hale.” Telephone interview. 12 Mar. 2012.
  3. May K, Ngo, T.D. and Hovig, D. Expanding contraceptive choices for women: Promising results for the IUD in sub-Saharan Africa. London: Marie Stopes International, 2011.
  4. “Interview with Victoria Hale.” Telephone interview. 12 Mar. 2012.
  5. Farley TM, Rosenberg MJ, Rowe PJ, et al. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet 1992;339(8796):785-88.
  6. WHO, Department of Reproductive Health and Research. “Hormonal Contraception and HIV.” Sexual and Reproductive Health. World Health Organization, 2012. Web. <http://www.who.int/reproductivehealth/topics/family_planning/hc_hiv/en/index.html>.
  7. Pollack AE, Ross J, Perkin G. Intrauterine devices (IUDs) in developing countries: Assessing opportunities for expanding access and use. Available at: http://www.hewlett.org/NR/rdonlyres/02DF606B-4918-4504-A55F-D71C9BC932B4/0/IUD.pdf.
  8. “Interview with Victoria Hale.” Telephone interview. 12 Mar. 2012.
  9. “Interview with Victoria Hale.” Telephone interview. 12 Mar. 2012.

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Category: Features, Print, Women and Children

About the Author ()

Audrey Zhang '15 is the webmaster for HCGHR and a Technology and Global Health online columnist. She is a resident of Adams House concentrating in History of Science with a focus on Medicine and Society, and a secondary field in Global Health and Health Policy. In her spare time, she enjoys competitive reading and Tazo tea.

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