Those of you who subscribe to Foresight’s free Weekly News Digest (sign up using the Join Email List box at upper right of our home page) have seen that practically every week there’s new positive results to report on nanotechnology for drug delivery, especially for cancer. A summary of where to read about these advances appears in Gregor Wolbring’s column of Dec. 15. At the end, he asks regarding nanoscale drug delivery systems:

What about the cost? Can a health care system afford them?

Good question. It seems as though if a person lives long enough, he or she gets cancer. Clearly, not every individual can afford the very latest in patented drugs, whether those drugs use nanoscale drug delivery or not. Nor is it clear that “a health care system” can afford them for everyone either.

Often, yesterday’s new drugs have been only marginally better than earlier ones for which patents have expired. The marginally-better new patented drugs are obtained by the wealthy and better-off patients, who pay high prices and benefit marginally. In other industries, this is called “cream-skimming” — selling expensive new products only to those who can afford them and are willing to put up with the bugs in any new product. Over time, technology improves, patents expire, prices drop, and then the average person (in wealthier countries) can afford the not-so-new product in which the bugs have now been ironed out.

Some of the nanomaterial-based drug delivery advances sound like significant improvements over what has come before, often by enabling better targeting of those nasty, toxic chemotherapy agents so they do less damage to healthy cells. If these new drugs are really a lot better — if they really work, as opposed to so many cancer treatments — we may want to find a way to speed up the process by which these innovations (often based on publicly-funded research) can reach those who are less well-off.

Patents are a big issue here. There’s increasing debate over whether the current system is the best we can come up with. It’s time to examine our experiences, in the U.S., with the Bayh-Dole Act and see if some tweaks might be needed. Meanwhile, the Peer-to-Patent Project is worth our support. It would be good to get this worked out now, when the advances are still relatively minor. Advanced molecular nanosystems should make really big medical innovations possible [Update: and, ultimately, affordable as well, as pointed out by Foresight advisor Glenn Reynolds]. —Christine