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- Okhravi, Christopher, 1987-
(författare)
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Composing Policy Interventions for Antibiotic Development
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Antibiotic resistance is eroding the efficacy of the drugs we have and, unless future science dictates otherwise, bacteria will eventually become resistant to whatever new antibiotics we discover. We must therefore plan for a continuous stream of innovation. Unfortunately, pharmaceutical firms have left the scene to pursue more profitable areas. While the free market may eventually give rise to a solution, the question is how much destruction we are willing to accept on the way, and whether it eventually will be too late. A plethora of policy interventions, aimed at stimulating antibiotic research and development, have been suggested, and simulation modelers have begun estimating their effects. Suggested interventions range from prizes, grants, and competitions to regulatory fast-tracking and non-profit development. No unified picture of what to do has emerged. From the perspective of policy-makers, the need does not seem to be for more but for better information. This thesis suggests that to truly compare policy interventions, aimed at stimulating antibiotic development, we should draw on simulation model alignment techniques. To support such an endeavor this thesis presents the seeds of a compositional language capable of formally expressing policy interventions as offers that can be actualized into contracts. The language is not merely theoretical but implementable and usable within actual simulation models. The language is not only derived from previous research on compositional contracts in functional languages and the resources-events-agents ontology, but also the author's unique position as a participant in DRIVE-AB, which comprised 16 public and 7 private partners from 12 countries, and finally six separately published simulation experiments that are all based on work by the author. A constructive proof is provided to establish the utility of the solution in terms of its capacity to capture important facets of important policy interventions.
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| 2. |
- Okhravi, Christopher
(författare)
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Economics of Public Antibiotics Development
- 2020
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Ingår i: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Issuing monetary incentives, such as market entry rewards, to stimulate private firm engagement has been championed as a solution to our urgent need for new antibiotics, but we ask whether it is economically rational to simply take public ownership of antibiotics development instead. We show that the cost of indirectly funding antibiotics development through late phase policy interventions, such as market entry rewards may actually be higher than simple direct funding. This result is reached by running a Monte Carlo simulation comparing the cost of increasing the ratio of investment go-decisions at the outset of pre-clinical development, to the cost of directly funding the same antibiotics under various levels of operational inefficiency. We simulate costs for hypothetical antibiotics targeting six different indications, using data from previous studies. We conclude that while indirect funding may be necessary for the current pipeline we may want to prefer direct funding as a cost effective long-term solution for future antibiotics.
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| 3. |
- Okhravi, Christopher, et al.
(författare)
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Simulating Market Entry Rewards for Antibiotics Development
- 2018
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Ingår i: Journal of Law, Medicine & Ethics. - : SAGE PUBLICATIONS INC. - 1073-1105 .- 1748-720X. ; 46, s. 32-42
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Tidskriftsartikel (refereegranskat)abstract
- We design an agent based Monte Carlo model of antibiotics research and development (R&D) to explore the effects of the policy intervention known as Market Entry Reward (MER) on the likelihood that an antibiotic entering pre-clinical development reaches the market. By means of sensitivity analysis we explore the interaction between the MER and four key parameters: projected net revenues, R&D costs, venture capitalists discount rates, and large pharmaceutical organizations' financial thresholds. We show that improving revenues may be more efficient than reducing costs, and thus confirm that this pull-based policy intervention effectively stimulates antibiotics R&D.
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| 4. |
- Okhravi, Christopher, et al.
(författare)
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Simulating Market-Oriented Policy Interventions for Stimulating Antibiotics Development
- 2017
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Ingår i: ANSS '17 Proceedings of the 50th Annual Simulation Symposium. - : ACM Digital Library.
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Konferensbidrag (refereegranskat)abstract
- The relative efficacy of intervention policies, aimed at stimulating development of antibiotics, can be estimated using Agent Based simulation. We propose that antibiotics development can be modeled as Markov Chains with time and cash loaded transitions, and that many intervention policies can be modeled as alterations to the stochastic distributions of said Markov Chains. Through the combination of these two models, Agent Based simulation can be used to estimate the relationship between interventions and the Expected Net Present Value of products. We apply this modeling to an intervention policy proposed by the EU-initiative DRIVE-AB, targeting the urgent need for antibiotics research and development due to increasing resistance. We focus on variants fully delinking profit from volume sales, and show that (1) implementation variations lead to differences in outcomes, and that (2) they exhibit diminishing returns.
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