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Genetic Discovery and the Need for Compulsory Licensing. Jon F. Merz Department of Medical Ethics and Center for Bioethics University of Pennsylvania School of Medicine. Acknowledgements. NHGRI/ELSI for funding
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Genetic Discovery and the Need for Compulsory Licensing Jon F. Merz Department of Medical Ethics and Center for Bioethics University of Pennsylvania School of Medicine
Acknowledgements • NHGRI/ELSI for funding • Collaboration of Mildred Cho, Debra Leonard, Michelle Henry, and other research staff • Survey respondents
Overview • Background to DNA patents • Review several survey studies examining licensing and use of DNA-based inventions • all studies approved by Penn or Stanford IRBs • copies of papers available • Ethical concerns
Definition • Human gene patents result from the cloning and description of the sequence of a gene, the role of which is “known” • Gene patents claim 2 types of “invention”: • Diagnostics – the characterization of an individual’s genetic makeup at a disease-associated locus when done for the purpose of diagnosis or prognosis • Therapeutics – use of the isolated and purified gene and derivative products (e.g., recombinant drugs, gene transfer)
Background • Focus on diagnostic use of gene patents • emerging predominance of diagnostics patents (Thomas et al. Nature 1996; 380:387; Nature 1997; 388:709)
Background • Focus on diagnostic use of gene patents • emerging predominance of diagnostics patents (Thomas et al. Nature 1996; 380:387; Nature 1997; 388:709) • Celera, Incyte, and Athersys have filed 10s of thousands of provisional applications on SNPs having diagnostic potential (The Scientist 2000; 14[5]:8)
Empirical Studies • Small interview study showed that, for a small sample of diagnostics patents, 14/27 had been licensed, all exclusively, all by universities (Schissel A, Merz JF, Cho MK. Nature 1999; 402:118) • Larger interview study examining the patenting and licensing of DNA-based inventions found: • universities appear to be generating greater number of inventions than firms (163 vs. 37), but are much less likely to file patent applications (15% vs. 86%) • with similar licensing rates (51% vs. 42%), universities are much more likely to grant exclusive licenses than are firms (68% vs. 27%) • Henry MR, Cho MK, Weaver MA, Merz JF. Science 2002; 297:1279. Full results under review.
Empirical Studies (continued) • Pilot survey of convenience sample of 74 laboratory staff found that ~1/4 reported being prevented from performing a patented test, and ~1/2 reported not developing/ validating a test because of known patents (Cho, M. K. in Preparing for the Millennium: Laboratory Medicine in the 21st Century 47-53 (AACC Press, 1998) • Interview study of 117/129 US labs regarding performance of HFE test for hemochromatosis showed many labs had adopted test before patent issued, and 26% of labs reported not developing/offering test and 4% reported dropping the test (Merz JF, Kriss AG, Leonard DGB, Cho MK. Nature 2002; 415:577-579)
Empirical Studies (continued) • Interview study of 132/211 US labs; 122 of which perform genetic testing • 79 (65%) had been contacted by a patent holder • 30 (25%) stated they stopped performing a test service • 17 for one test, 12 for more than one test • for-profit labs more likely stopped than university labs (P=0.001) • 64 (53%) decided not to develop or perform a clinical genetic test because of a patent Cho MK, Illangasekare S, Weaver MA, Leonard DGB, Merz JF., Molecular Diagnostics 2003; forthcoming
Patents may impact lab medicine • ability to prescribe nationwide medical standard of care • may restrict access by requiring prepayment, charging higher prices, refusing Medicaid reimbursement • may subvert education, counseling of providers/patients • potential lack of adequate quality control • may limit types of “permissible” testing • increase prices and hospital costs • royalty demands • stacking of royalties
Patents may inhibit research • inhibit widespread clinical use and observation • external study/validation and new discovery • impose reach-through conditions (e.g., royalties, rights of first refusal, back-licensing of downstream discoveries) • impose unethical constraints (e.g., limit clinical uses of research results) • constrain new testing technologies (e.g., DNA chips) • Heller & Eisenberg’s “tragedy of the anticommons” • many owners of pieces of the genome inhibit use by anyone
Summary • 1996 amendment of patent law exempts physicians and institutions from infringement liability for “pure process” patents • do not apply to CLIA lab services or to “biotech” patents • Gene patents are having a measurable effect on physician practices • laboratorians are willing to pay reasonable royalties, but want to be free to practice medicine • Professional services should be subject to compulsory licenses • a law analogy