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On December 3, IIPP Fellow Victor Roy听travelled to Geneva to speak at .听The focus for this one-day symposium, organised in collaboration with the and the , was on听the global challenge of improving access to new breakthrough medicines.听Using relatively new curative treatments for hepatitis C virus (HCV) as an extended case study, the attendees pursued novel thinking around how to scale up treatment and also ensure that future breakthroughs are accessible to all who need them.听

Roy, who is a practicing physician and completed a doctorate in the political economy of biomedical innovation, spoke on a panel that focused specifically on evolutions in innovation models. The panel featured speakers from the industry, including a member of 鈥� public policy team as well as the head of , a global non-profit R&D network. Roy听spoke specifically about the significant role of the public sector in the process,听and challenged the audience to reflect on the core principles that should underpin the enterprise of developing new drugs.听听

鈥淚nnovation not only has a rate but a direction. We often talk about the pace and speed of drug development but how do we realise those real breakthrough directions for health? Not just the incremental advances, but the kinds of medicines that transform care for a particular health need,鈥� said Roy.

Roy used his platform to share ideas based on his research here at IIPP about 迟丑别听role of the public sector in facilitating long-term value creation. He argued that while the state鈥檚 contributions are often 鈥榖lack boxed鈥� as basic science, public investments play a key role across multiple stages of the process. The state is often the first entity to invest in long-term patient investment, harbouring the initial risks at the early stages and laying the groundwork, long before private sector businesses get involved. Then, once public sector-led research has created impressive听breakthroughs in the field, the initial public sector success then crowds in private investment.听听

Giving specific examples of his research, Roy pointed to the case of the hepatitis C virus.听听For a decade after its identification in 1989, the hepatitis C virus could not be grown in cell culture in a lab, so drug developers had no efficient way to test components of the virus to stop the replication of it. However, thanks to investment from the German and US government, through听迟丑别听US Small Business Innovation Research Programme, funding the Charles M.Rice at Rockefeller University听and his fellow scientists, they were able to develop the (that allowed the virus to be grown in the lab). This paved the way for drug developers to听revolutionise the treatment of this disease. Later, public investments also supported the start-up business that would ultimately develop the curative backbone of the most widely used hepatitis C treatment,听sofosbuvir.听

Yet access to the treatments were threatened due to the launch prices of the treatments in high income countries. The story of hepatitis C has been well documented in the media, including Roy鈥檚 . In his comments in Geneva, Roy closed by asking an all important question: 鈥淗ow can听we build 鈥榓ccess鈥� into the design features of future innovation models? Not as a听辫辞蝉迟-丑辞肠听consideration, but as an听别虫-补苍迟别听design requirement?鈥澨�

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Rethinking Value in Health Innovation: from mystifications towards prescriptions

Mariana Mazzucato,听Victor Roy