EB144: KEI statement on the WHO Cancer report

Knowledge Ecology International (KEI) delivered the following intervention on the WHO Cancer report (agenda item 5.7.2) on Tuesday evening, 29 January 2019.

We commend the WHO secretariat for the 171-page report on “Pricing of cancer medicines and its impacts.”

A key recommendation is that international action is required to improve transparency in reporting the costs of R&D and production, including public sources of funding. There should be an EB follow-through on this point.

The report underscored that “[e]stimates of R&D costs, including for cancer medicines, are highly variable and not transparent,” that prices limit access, and that cumulative sales for several drugs are enormous.

Companies may object to data presented in the report, but their objection is an argument to have more transparency of pricing, sales revenue and R&D costs. Policy should be based upon best evidence.

We agree with the report that prices for cancer drugs are not based upon R&D costs, but also note that incentives to invest in R&D are linked to prices. This creates a conflict, or policy incoherence, between access and affordability on the one hand, and innovation on the other.

The WHO needs to host a meeting to look at the feasibility of progressively delinking R&D incentives from prices, so that efforts to make cancer treatments more affordable do not conflict with innovation objectives.

Finally, we suggest the WHO evaluate the role of gene and cell – based treatments for cancer, including CAR T, and such issues as equality of access, and the extent to which patent exceptions for diagnostic, therapeutic and surgical methods for the treatment of humans will apply, and if so, how should incentives be reinvented.

In general, many in the public health community know it is essential to delink incentives from prices, but also don’t know much about how delinkage can be implemented, progressively. This needs to be fixed as we move forward.