Glossary

Terminology in the field of medical funding mechanisms is non-standard. This glossary presents important terms and concepts, and offers an interpretation.

Access

Access To Medicines (ATM) ‘is defined as having medicines continuously available and affordable at public or private health facilities or medicine outlets that are within one hour’s walk from the homes of the population’.1 A pared down way of defining access if the proportion of the potential beneficiaries of a given treatment who indeed receive the treatment. See here for more information.

Deadweight loss

Deadweight loss is a loss of economic efficiency. The phrase often describes circumstances where consumers want to buy what a producer wants to sell, but this fails to happen because of a market inefficiency, often with regards pricing. Scotchmer writes, ‘Deadweight loss occurs when people are excluded from using the good even though their willingnesses to pay are higher than the marginal cost.’2 This is a particular problem in monopoly settings, were lack of competition means that the price can be set at a high level, thus excluding those with lower willingness to pay. It also becomes an especially stark problem in the case of information goods, where the marginal cost is very low or even nothing (and thus the most efficient distribution would be to grant universal access).

Delinkage

Any system which separates the cost of R&D from the price of drugs. Used more commonly by activists3 than academics.4 Also used by the WHO.5

Extended collective licensing

ECL is a form of licensing whereby the government grants a collecting society the right to grant licenses on all works of a particular class, or all uses of a particular class. This would apply to rightholders who were non-members as well as members, unless the non-members explicitly opted out. ECL is sometimes seen as a halfway house between compulsory and voluntary licensing.6 It has been used in Nordic countries, and was introduced in the UK in 2014.7 Versions of ECL have also been recently introduced in France and Germany.8 The famous settlement of the Google Books case in 2009 concerning the mass digitization of books has been likened to ECL. It provided that Google could digitize out of print books unless their rightholders opted out.9

Health Impact Funds

Occasionally used as a general term for remuneration rights systems, with the HIF as its primary example.10

Marginal cost

Marginal cost means the additional cost of producing one more unit of a good or service. It is different from the average cost, which includes fixed costs as well as variable costs. Marginal costs only include the variable costs (once the factory has been built in the first place, there is no additional fixed cost to producing one more rubber toy). In the case of information goods, marginal costs are low and fixed costs high.

Market-based

In general terms, a market-based economy is organised by the balance of supply and demand, rather than by the government. On the demand side, market-based means that there is competition of manufacture and sale. On the supply side, market-based means that investment is decentralised.

Opportunity cost

Money spent on an internal project could have been invested and reaped interest. The opportunity cost of capital is the incremental return on investment which is forgone whenever an innovator chooses to spend money on a project rather than invest it.

Pay-For-Performance

Used as a descriptor of the HIF, in that it rewards successful research only.11 Also used by Mossialos and Outterson to describe a general approach involving paying for performance rather than quantity or some other factor.12

Prize funds

Usually used synonymously with remuneration rights, to describe a fund which remunerates innovators on registration of their innovation.13 Can also describe one-off milestone or end prizes.14 Sometimes used for MRDT.15 Many initiatives include ‘prize fund’ in their title.16

Prizes

Usually refers to one-off milestone or end prizes. Sometimes includes prize funds like HIF17 and MIPF.18 At other times, used to describe a pull funding mechanism in contradistinction to patents.19

Remuneration rights

A system where innovators are awarded repeated remuneration rights after registering their innovation. Remuneration rights would give their owners the right to payment from a central fund according to the value generated by the innovation: how much a given drug improved health

Bibliography

“Chagas Disease Prize Fund for the Development of New Treatments, Diagnostics and Vaccines.” PROPOSAL by Bangladesh, Barbados, Bolivia and Suriname, 2009. http://www.who.int/phi/Bangladesh_Barbados_Bolivia_Suriname_ChagasPrize.pdf.

“DACS - Knowledge Base - Extended Collective Licensing Frequently Asked Questions.” Accessed September 7, 2017. https://www.dacs.org.uk/knowledge-base/ecl-frequently-asked-questions#FAQ264.

“Delivering on the Global Partnership for Achieving the Millennium Development Goals.” United Nations, MDG Gap Task Force, 2008. http://www.who.int/medicines/mdg/MDG08ChapterEMedsEn.pdf.

“Extended Collective Licensing: A Way Forward on Book Digitization?” Accessed September 7, 2017. https://www.brookings.edu/blog/techtank/2015/07/01/extended-collective-licensing-a-way-forward-on-book-digitization/.

Faunce, Thomas Alured, and Hitoshi Nasu. “Three Proposals for Rewarding Novel Health Technologies Benefiting People Living in Poverty: A Comparative Analysis of Prize Funds, Health Impact Funds and a Cost-Effectiveness/ Competitive Tender Treaty.” Public Health Ethics 1 (2008).

Hancock, Kimberly. “1997 Canadian Copyright Act Revisions.” Berkeley Technology Law Journal, 1998, 517–534.

Hecht, Robert, Paul Wilson, and Amrita Palriwala. “Improving Health R&d Financing for Developing Countries: A Menu of Innovative Policy Options.” Health Affairs (Project Hope) 28, no. 4 (2009): 974–85. https://doi.org/10.1377/hlthaff.28.4.974.

Hoffman, Steven J., and Karen So. “Assessing 15 Proposals for Promoting Innovation and Access to Medicines Globally.” Annals of Global Health, Tropical Medicine in the Era of Global Connectivity, 80, no. 6 (2014): 432–43. https://doi.org/10.1016/j.aogh.2015.02.004.

Hollis, Aidan, and Thomas Pogge. The Health Impact Fund: Making New Medicines Accessible for All. Incentives for Global Health, 2008. http://healthimpactfund.org/wp-content/uploads/2015/12/hif_book.pdf.

Kevin Outterson. “New Business Models for Sustainable Antibiotics.” Working Groups on Antimicrobial Resistance. Chatham House, 2014. https://www.chathamhouse.org/sites/files/chathamhouse/public/Research/Global%20Health/0214SustainableAntibiotics.pdf.

Kretschmer, Martin. “Digital Copyright: The End of an Era.” European Intellectual Property Review 25, no. 8 (2003): 333–341.

Love, James, and Tim Hubbard. “Prizes for Innovation of New Medicines and Vaccines.” Annals of Health Law 18, no. 2 (2009): 155–86, 8 p. preceding i.

———. “The Big Idea: Prizes to Stimulate R&D for New Medicines.” Chicago-Kent Law Review 82 (2007): 1519.

“Orphan Works and Mass Digitization.” A report of the register of copyrights, 2015. https://copyright.gov/orphan/reports/orphan-works2015.pdf.

“Prize Fund for Development of Low-Cost Rapid Diagnostic Test for Tuberculosis.” WORKING DOCUMENT - BARBADOS AND BOLIVIA, 2009. https://www.keionline.org/misc-docs/b_b_igwg/prop1_tb_prize.pdf.

Renwick, Matthew, David M. Brogan, and Elias Mossialos. “A Systematic Review and Critical Assessment of Incentive Strategies for Discovery and Development of Novel Antibiotics,” 2015. http://eprints.lse.ac.uk/64852/1/Mossialos_systematic_review_and_critical_assessment1.pdf.

“Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination.” Report of the Consultative Expert Working Group on Research and Development: Financing and Coordination. World Health Organisation, 2012. http://apps.who.int/iris/bitstream/10665/254706/1/9789241503457-eng.pdf?ua=1.

Scotchmer, Suzanne. Innovation and Incentives. Cambridge, Mass. ; London: MIT Press, 2004.

Stiglitz, Joseph E. “Economic Foundations of Intellectual Property Rights.” Duke Law Journal 57, no. 6 (2008): 1693–1724. https://doi.org/10.2307/40040630.

“The Medical Innovation Prize Fund: A New Paradigm for Supporting Sustainable Innovation and Access to New Drugs: De-Linking Markets for Products from Markets for Innovation,” 2011. https://www.keionline.org/sites/default/files/big_prize_fund_overview_26may2011_letter.pdf.

Wan, Yong. “Legal Protection of Performers’ Rights in the Chinese Copyright Law.” J. Copyright Soc’y USA 56 (2008): 669.

Wei, Marlynn. “Should Prizes Replace Patents - A Critique of the Medical Innovation Prize Act of 2005.” Boston University Journal of Science & Technology Law 13 (2007): 25.

Wolke, Kara M. “Some Catching Up To Do: How The United States, In Refusing To Fully Sign On To The WPPT’S Public Performance Right In Sound Recordings, Fell Behind The Protections Of Artists’ Rights Recognized Elsewhere In This Increasingly Global Music Community.” Vand. J. Ent. L. & Prac. 7 (2004): 411.

Xue, Hong. “One Step Ahead, Two Steps Back: Reverse Engineering the Second Draft for the Third Revision of the Chinese Copyright Law.” Am. U. Int’l L. Rev. 28 (2012): 295.


  1. “Delivering on the Global Partnership for Achieving the Millennium Development Goals”, p. 35. [return]
  2. Scotchmer, Suzanne. Innovation and Incentives. Cambridge, Mass. ; London: MIT Press, 2004, p. 36. [return]
  3. Especially Love. See for example Love and Hubbard, “Prizes for Innovation of New Medicines and Vaccines.” [return]
  4. For exceptions see Renwick, Brogan, and Mossialos, “A Systematic Review and Critical Assessment of Incentive Strategies for Discovery and Development of Novel Antibiotics” and Hoffman and So, “Assessing 15 Proposals for Promoting Innovation and Access to Medicines Globally.” [return]
  5. “Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination.” [return]
  6. “Orphan Works and Mass Digitization.” A report of the register of copyrights, 2015. https://copyright.gov/orphan/reports/orphan-works2015.pdf, p. 82. [return]
  7. “DACS - Knowledge Base - Extended Collective Licensing Frequently Asked Questions.” Accessed September 7, 2017. https://www.dacs.org.uk/knowledge-base/ecl-frequently-asked-questions#FAQ264. [return]
  8. “Orphan Works and Mass Digitization.” A report of the register of copyrights, 2015. https://copyright.gov/orphan/reports/orphan-works2015.pdf, p. 83. [return]
  9. “Extended Collective Licensing: A Way Forward on Book Digitization?” Accessed September 7, 2017. https://www.brookings.edu/blog/techtank/2015/07/01/extended-collective-licensing-a-way-forward-on-book-digitization/. [return]
  10. Faunce and Nasu, “Three Proposals for Rewarding Novel Health Technologies Benefiting People Living in Poverty: A Comparative Analysis of Prize Funds, Health Impact Funds and a Cost-Effectiveness/ Competitive Tender Treaty”; Hollis and Pogge, The Health Impact Fund: Making New Medicines Accessible for All. [return]
  11. Hollis and Pogge, The Health Impact Fund: Making New Medicines Accessible for All. [return]
  12. Kevin Outterson, “New Business Models for Sustainable Antibiotics”; Renwick, Brogan, and Mossialos, “A Systematic Review and Critical Assessment of Incentive Strategies for Discovery and Development of Novel Antibiotics.” [return]
  13. Love and Hubbard, “The Big Idea.” [return]
  14. “Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination.” [return]
  15. Faunce and Nasu, “Three Proposals for Rewarding Novel Health Technologies Benefiting People Living in Poverty: A Comparative Analysis of Prize Funds, Health Impact Funds and a Cost-Effectiveness/ Competitive Tender Treaty.” [return]
  16. “Chagas Disease Prize Fund for the Development of New Treatments, Diagnostics and Vaccines”; “Prize Fund for Development of Low-Cost Rapid Diagnostic Test for Tuberculosis”; “The Medical Innovation Prize Fund: A New Paradigm for Supporting Sustainable Innovation and Access to New Drugs: De-Linking Markets for Products from Markets for Innovation.” [return]
  17. Hecht, Wilson, and Palriwala, “Improving Health R&d Financing for Developing Countries”; Love and Hubbard, “Prizes for Innovation of New Medicines and Vaccines.” [return]
  18. Wei, “Should Prizes Replace Patents - A Critique of the Medical Innovation Prize Act of 2005.” [return]
  19. Stiglitz, “Economic Foundations of Intellectual Property Rights”, p. 1722. [return]