忘れられた病気のための薬の開発: 欠陥のある市場と公衆衛生政策の失敗
Patrice Trouiller1, Piero Olliaro, Els Torreele
1Centre Hospitalier Universitaire, BP 217, 38043 Grenoble cedex 9, France. PTrouiller@chu-grenoble.fr
Lancet (London, England)
|July 2, 2002
まとめ
製薬会社は,低利益のために発展途上国の病気を無視しています. 忘れられた熱帯病や結核の治療薬の開発には,新しい戦略と国際的政策が必要である.
科学分野:
- 医薬品のR&Dについて
- グローバル・ヘルス グローバル・ヘルス
- ドラッグ・ディスカバリー・ドリッグ・ディスカバリー・ドリッグ・ディスカバリー・ドリッグ・ディスカバリー
背景:
- 感染症は,開発途上国の貧困層に不均衡な影響を及ぼし,著しい死亡率と罹患率をもたらしています.
- これらの軽視された疾患に対する有効で安全で手頃な価格の医薬品の開発には重大なギャップが存在します.
- 収益性のある市場に焦点を当てている製薬業界は,グローバル・サウスで蔓延している病気を十分に扱っていない.
研究 の 目的:
- 25年間の医薬品研究開発 (R&D) の動向を分析する.
- 軽視された疾患に関するR&Dの不均衡に対処する既存の公的・私的イニシアチブを見直す.
- 貧しい人々に影響を与える病気のための持続可能な薬物開発のための必要な戦略を特定する.
主な方法:
- メドラインと規制データベース (米国FDA,欧州EMA) の検索.
- 1975年から1999年の間に販売された新化学エンティティ (NCE) の分析.
- 軽視された病気に対する公的・私的なイニシアティブに関する出版された研究のレビュー.
主要な成果:
- 販売された1393のNCE (1975年−1999年) のうち,熱帯病と結核を標的としたものは16件のみであった.
- 中枢神経系 (CNS) やがん治療薬と比較して,軽視された疾患の薬が市場に到達する確率は13倍も低い.
- 業界は,高額なR&Dコストと低いリターンを,見捨てられた病気への投資の障壁として挙げています.
結論:
- 現在のR&Dモデルは,主に貧困層に影響を与える病気に対処するのに不十分です.
- 公私パートナーシップとインセンティブは,市場の制約を完全に克服していない.
- 持続可能な解決策には,見捨てられた病気に対する国際的な医薬品政策,民間部門の義務の検討,公共の非営利のR&Dの促進が必要です.
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