[EQ] The U.S. Commitment to Global Health

The U.S. Commitment to Global Health  - 2008 Report

 

Available online at: http://www.nap.edu/catalog.php?record_id=12506

The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area.

the committee considered the following key areas of U.S. government engagement in global health:
- the financial and technical resources provided to countries to expand public health infrastructure and improve access to health interventions;
- the governance structures across U.S. agencies responsible for delivering these benefits;
- the research effort that focuses on health problems endemic to poor countries; and
- the relationship of the United States with the World Health Organization (WHO), the leading global agency in the field of health policy.

While the scope of this report was limited to U.S. government efforts in the realm of global health, this topic is inevitably linked to broader discussions on U.S. commitments to global economic development and the environment.2 This report does not, however, cover the related areas of food security, water and sanitation, climate change, educational and economic opportunity, and gender equity. Similarly, the committee was not tasked with evaluating or recommending action on broader international development reforms..."

Contents

Summary
Charge to the committee
A prominent role for health in U.S. foreign policy
Progress in global health can be achieved now
Urgent opportunity for action
Restructure the U.S. global health enterprise
Mobilize financial resources for health
Focus U.S. government efforts on health outcomes
Advance U.S. strengths in global health knowledge
Support and collaborate with the WHO
Call to action

Harold Varmus to present Barmes lecture Dec. 16, 2008

Dr. Harold Varmus

The National Institute of Dental and Craniofacial Research and the Fogarty International Center, together with the Foundation for NIH, present the 2008 David E. Barmes Global Health Lecture:

"The U.S. Commitment to Global Health"

 videocast. (http://videocast.nih.gov/)

Harold Varmus, former Director of the National Institutes of Health and co-recipient of a Nobel Prize for studies of the genetic basis of cancer, is President of Memorial Sloan-Kettering Cancer Center in New York City.

Dr. Varmus chairs the Scientific Board of the Bill & Melinda Gates Foundation's Grand Challenges in Global Health program and leads the Advisory Committee for the Global Health Division. He was a member of the World Health Organization (WHO) Commission on Macroeconomics and Health, and is a co-founder of the Public Library of Science, a leading publisher of open access journals. In addition, he serves as co-chair of the Institute of Medicine's committee on The U.S. Commitment to Global Health. The committee has issued its interim report on the day preceding the lecture.

NIDCR and Fogarty jointly host the annual Barmes Lecture, which honors the late David E. Barmes. Dr. Barmes was a special expert for international health at the NIDCR. Prior to joining NIDCR, he served in senior management positions related to oral health, health promotion, and non-communicable diseases at the World Health Organization in Geneva.

The reception is sponsored by the Foundation for the National Institutes of Health, with generous support from Lilly, Abbott Fund, Bristol-Myers Squibb Foundation, ExxonMobil, PepsiCo, Aeras Global TB Vaccine Foundation, Burroughs Wellcome Fund, Merck, Pfizer, Tibotec, and the United Nations Foundation.

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

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[EQ] The Effect Of Regulation On Pharmaceutical Revenues: Experience In Nineteen Countries

D R U G  S P E N D I N G - 16 December 2008  - Health Affairs 
 

Drug Spending In The U.S. And Abroad

"...In two papers published today on the Health Affairs Web site, researchers from the RAND Corporation warn that introducing European-style price controls on prescription drugs into the United States could have large negative effects on the revenues of pharmaceutical manufacturers and the welfare of consumers. The papers are part of a five-paper package on prescription drugs released today by Health Affairs.

In a third article, Murray Aitken of IMS Health and coauthors argue that spending on prescription drugs has reached a turning point and that U.S. drug spending will grow more slowly in coming years than in the recent past. In a fourth paper, Arjun Jayadev of the University of Massachusetts and Nobel economics laureate Joseph Stiglitz of Columbia University make the case for value-based pricing of pharmaceuticals and public financing of clinical trials. Finally, Harvard's F.M. Scherer questions the way that one of the RAND papers estimates the extent to which declines in profits for drugmakers are likely to translate into declines in pharmaceutical innovation.

Access the package here: http://content.healthaffairs.org/cgi/content/full/hlthaff.28.1.w125/DC3

Health Affairs is pleased to make this 5-paper package freely accessible to listserv recipients for two weeks.....'  [From: "Ford, Kathleen]

The Effect Of Regulation On Pharmaceutical Revenues: Experience In Nineteen Countries
Neeraj Sood, Han de Vries, Italo Gutierrez, Darius N. Lakdawalla, and Dana P. Goldman

"......We describe pharmaceutical regulations in nineteen developed countries from 1992 to 2004 and analyze how different regulations affect pharmaceutical revenues.
First, there has been a trend toward increased regulation.
Second, most regulations reduce pharmaceutical revenues significantly.
Third, since 1994, most countries adopting new regulations already had some regulation in place. We find that incremental regulation of this kind had a smaller impact on costs.
However, introducing new regulations in a largely unregulated market, such as the United States, could greatly reduce pharmaceutical revenues.
Finally, we show that the cost-reducing effects of price controls increase the longer they remain in place. ...'

[Health Affairs 28, no. 1 (2009): w125-w137 (published online 16 December 2008; 10.1377/hlthaff.28.1.w125)]

U.S. Pharmaceutical Policy In A Global Marketplace
Darius N. Lakdawalla, Dana P. Goldman, Pierre-Carl Michaud, Neeraj Sood, Robert Lempert,
Ze Cong, Han de Vries, and Italo Gutierrez

".....U.S. consumers generate more pharmaceutical revenue per person than Europeans do.
This has led some U.S. policymakers to call for limits on U.S. pharmaceutical spending and prices.
Using a microsimulation approach, we analyze the welfare impacts of lowering U.S. prices toward European levels,
and how these impacts vary with key modeling assumptions. Under the assumptions most favorable to them,
price controls generate modest benefits (a few thousand dollars per person). However, for the remainder of plausible
assumptions, price controls generate costs that are an order of magnitude higher.
In contrast, publicly financing reductions in consumer prices, without affecting manufacturer prices, delivers benefits in virtually all plausible cases

Prescription Drug Spending Trends In The United States: Looking Beyond The Turning Point
Murray Aitken, Ernst R. Berndt, and David M. Cutler

'....Annual growth in real prescription drug spending averaged 9.9 percent during 1997-2007 but has slowed since 2003,
falling to 1.6 percent in 2007. More patent expirations, increased generic penetration, and reduced new product innovations
have contributed to this turning point. We document trends and identify underlying components: declines in the role of
blockbuster drugs, increased importance of biologics and vaccines relative to traditional pharmaceuticals, and a changing
medication mix away from those prescribed principally by primary care physicians toward those mostly prescribed by specialists.
We conclude with policy implications...."

Price Controls And Global Pharmaceutical Progress
F. M. Scherer

"....An alternative explanation for the sizable access effects is that blockbusters are heavily promoted, both directly to consumers and
through detailing (promotion to medical professionals), and the hoopla surrounding their marketing causes physicians to confront
and deal with symptoms of which they were previously unaware or unresponsive. To the extent that this explanation has validity,
better, more objective, continuing education of physicians seems warranted. The paper by Murray Aitken and colleagues suggests
that changes, including greater use of generics and perhaps an ebbing of the access effect, have been emerging in recent years,
more through the incentives generated by insurers' tiered reimbursement systems than through any change in physicians' behavior..."

Two Ideas To Increase Innovation And Reduce Pharmaceutical Costs And Prices
Arjun Jayadev and Joseph Stiglitz

"....The pharmaceutical industry is undergoing a period of uncertainty. Profits are being squeezed by increasing costs and
competitive pressures, and new drug production is slowing down. This Perspective reviews two policies that could
assist in realigning incentives toward genuine innovation while also keeping drug spending growth under check.
Value-based pricing can incentivize genuinely new discoveries and align research and development with social welfare.
Public funding of clinical trials likewise can reduce both pharmaceutical costs and prices and direct research effort
in a manner that is more socially productive than the current state of affairs..."

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.