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PubMed2002

The Human Genome Project and the future of diagnostics, treatment and prevention.

The Human Genome Project, the mapping of our 30,000-50,000 genes and the sequencing of all of our DNA, will have major impact on biomedical research and the whole of therapeutic and preventive health care. The tracing of genetic diseases to their molecular causes is rapidly expanding diagnostic and preventive options. The increased insights into molecular pathways, gained from high-throughput 'functional genomics', using DNA-chip and protein-chip approaches and specially designed animal model systems, will open great prospects for pharmacological and genetic therapies. Powerful bioinformatics and biostatistics will further improve our pattern recognition and accelerate progress. A rapidly expanding area of high expectations is that of 'pharmacogenomics': the design of more effective drugs with lower toxicity through tailoring of drug treatment to individual, genetically determined differences in drug metabolism. Not only will this decrease the cost of health care through reduction of adverse drug reactions, but a better stratification of populations will also provide more statistical power farther upstream in drug trials. However, the optimal benefits from the current explosion of 'data mining' will only be realized when the basic data are made and kept publicly accessible, while at the same time safeguarding the protection of intellectual property arising from downstream inventions. This is one of the goals of HUGO, the international Human Genome Organization, established 13 years ago to assist coordination of data acquisition and exchange and societal implementation of the genome project. Additional points of attention in this historic endeavour are the prevention of stigmatization and discrimination and the safeguarding of a worldwide balance in the contribution by--and benefits to--different populations, while respecting the diversity in cultures and traditions.

Ethics, Medical↗
PubMed2004

Fair drug prices and the patent system.

This paper uses John Rawls' theory of justice to defend the patent system against charges that it has an unfair effect on access to medications,from the perspective of national and international justice. The paper argues that the patent system is fair in a national context because it respects intellectual property rights and it benefits the least advantaged members of society by providing incentives for inventors, investors, and entrepreneurs. The paper also argues that the patent system is fair in an international context, provided that developed nations take steps to help disease-stricken countries secure internal justice. Fairness in a national or international context also requires that the patent system should include emergency exceptions to deal with short-term inequities.

Drug Industry↗
PubMed2001

Microarrays: lost in a storm of data?

Microarray expression profiling is instrumental to our understanding of the function of the genome. Resolution of functionally relevant expression patterns will require the analysis of large data sets compiled from multiple investigators. For this and other reasons, I argue that it is crucial for array data to be publicly shared in a format as close to the 'raw data' as possible. Issues such as protection of intellectual property, ensuring quality of the data, and the format and timing for sharing array data are also discussed.

Animals↗
PubMed2000

Structural genomics in the biotechnology sector.

Commercial efforts in structural genomics focus on providing to pharmaceutical customers information that relates to the suitability of specific proteins as drug targets and the informed selection and refinement of lead compounds generated by high-throughput screening and rational approaches. These efforts follow a variety of business models and are impacted by activities in the public domain, recent technological advances, and the changing intellectual property landscape.

Animals↗
PubMed2005

Whole-genome patenting.

Gene patenting is now a familiar commercial practice, but there is little awareness that several patents claim ownership of the complete genome sequence of a prokaryote or virus. When these patents are analysed and compared to those for other biological entities, it becomes clear that genome patents seek to exploit the genome as an information base and are part of a broader shift towards intangible intellectual property in genomics.

Genome, Bacterial↗
PubMed2004

Crystal engineering of the composition of pharmaceutical phases. Do pharmaceutical co-crystals represent a new path to improved medicines?

The evolution of crystal engineering into a form of supramolecular synthesis is discussed in the context of problems and opportunities in the pharmaceutical industry. Specifically, it has become clear that a wide array of multiple component pharmaceutical phases, so called pharmaceutical co-crystals, can be rationally designed using crystal engineering, and the strategy affords new intellectual property and enhanced properties for pharmaceutical substances.

Acids↗
PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗
PubMed2003

Guidelines for presentations and publications.

The oral and written presentation of work arising from clinical practice, service development, quality improvement projects and research is presently encouraged and supported. Because this work may involve consumers, staff and the organization, it is important that proper consideration is given to how the work is disseminated, including any ethical implications. There is a need to ensure that consumers, staff, facilities, the organization and intellectual property are protected from any potential concerns that may arise. This research note provides protocols and a checklist that may be of interest and may be relevant for clinicians and researchers to review and appraise their work before oral or written presentation.

Guidelines as Topic↗
PubMed2001

Towards a Statewide Cardiac Surgery Database: the Victorian initiative.

The establishment of the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) at the beginning of the 1990s gave rise to an early proposal for the development of a cardiac surgical database. The Victorian Government gave its in-principle backing to a statewide database project from late 1997. Release of a promised dollar 200,000 grant for development was contingent on the ASCTS being able to fulfil several initial requirements. These were: (i) the provision of an indicative annual report outlining performance against a series of clinical indicators; (ii) an indicative peer-review process; and (iii) the addressing of issues surrounding intellectual property and ownership of any database that was developed. In outlining a strategy to be used in developing and implementing the project plan, it was determined by the project development team that all Victorian cardiac surgical units were, in fact, collecting similar data, but were using different software and analytical tools. The Cardiovascular Disease Prevention Unit at the Baker Medical Research Institute in Melbourne has developed a model of mortality and risk-adjusted complications out of the pooled Victorian data. This, it is hoped, will be a forerunner of a major achievement in the monitoring of cardiac surgery procedures nationally, and the attainment of national and international best practice.

Journal Article↗
PubMed2003

Research governance: implications for health library and information professionals.

The Research Governance Framework for Health and Social Care published by the Department of Health in 2001 provides a model of best practice and a framework for research in the health and social care sector. This article reviews the Department of Health Research Governance Framework, discusses the implications of research governance for library and information professionals undertaking research in the health- and social-care sector and recommends strategies for best practice within the information profession relating to research governance. The scope of the Framework document that covers both clinical and non-clinical research is outlined. Any research involving, amongst other issues, patients, NHS staff and use or access to NHS premises may require ethics committee approval. Particular reference is made to the roles, responsibilities and professional conduct and the systems needed to support effective research practice. Issues such as these combine to encourage the development of a quality research culture which supports best practice. Questions arise regarding the training and experience of researchers, and access to the necessary information and support. The use of the Framework to guide research practice complements the quality issues within the evidence-based practice movement and supports the ongoing development of a quality research culture. Recommendations are given in relation to the document's five domains of ethics, science, information, health and safety and finance and intellectual property. Practical recommendations are offered for incorporating research governance into research practice in ways which conform to the Framework's standards and which are particularly relevant for research practitioners in information science. Concluding comments support the use of the Research Governance Framework as a model for best practice.

Benchmarking↗
PubMed2002

Twenty-eight years of clinical experience with implantable neuroprostheses for various applications.

Since 1973, the author has been implanting neural stimulators and later drug pumps to restore or improve motor function and modulate pain, spasticity, and seizures in patients with spinal cord and brain injury, cerebral palsy, stroke, and multiple sclerosis. During these 28 years, many physicians, biomedical engineers, and manufactures have realized worthwhile successes. Many lessons have been learned to improve operative techniques to ensure safety, low infection, and improved results for implant patients. The relationships between manufacturers and physicians have varied. Problems arise with patents, royalties, confidentiality, publishing, and liability insurance. There has been a need to patent ideas and intellectual properties; however, some of the patented concepts have been published previously but missed by the patent author and patent office. This has led to vigorous legal battles, consuming money with time delays, or resulting in surrendering worthwhile projects. There is a need for a responsible, independent appeals board to review these disputed patent claims. Then their findings should be admissible at the Patent Office and if necessary in court.

Biomedical Engineering↗
PubMedDate not supplied

[The supply of breast/ovarian cancer genetic susceptibility tests in France].

One example of the recent advances of scientific research on the human genome is the identification of two susceptibility genes to breast/ovarian cancer, BRCA1 and BRCA2, making possible the introduction in medical practices of genetic testing to detect patients with an increased risk of developing such cancers. In this context of diffusion, two surveys were carried out to appraise the activity profiles in 1998 and in 2001 of all the different participants in those new medical practices in France, physicians in charge of genetic counselling, medical centres where consultations take place and laboratories. Results show that over the period 1998-2001, few changes occurred, mainly the reduction of the average waiting time to get the result of a genetic test, the increase in the annual number of BRCA2 families identified to a level similar to the one of BRCA1 and the automation of the biological analyses without noting a considerable increase in the annual output of laboratories till 2001 however. This surprising moderate evolution must be connected to the existence of some particular external factors making the framework of the development of these new medical and biological practices and their future really uncertain. The diffusion of BRCA1/2 genetic testing has been carried out facing the traditional difficulties of any innovating activities, but also the uncertainties related to intellectual property rights on genes and the reimbursement of genetic counselling and biological testing. These uncertainties have certainly restrained the pace of change as many actors in this field have opted for a wait and see strategy bearing in mind the possible future constraints imposed to their future activity, especially if European patents on the BRCA1/2 genes are finally granted by the European patent office (EPO).

Breast Neoplasms↗
PubMedDate not supplied

[Opposition to Myriad Genetics patents and their total or partial revocation in Europe: early conclusions].

The proceedings instituted against three European patents held by the US company Myriad Genetics, on the BRCA1 gene and the breast cancer diagnosis gene, resulted in the total or partial revocation of these patents. These decisions put an end to the legal monopoly claimed by Myriad Genetics on the BRCA1 gene and on breast cancer gene tests, and left the field open to European geneticists to develop and implement their test methods within the framework of a clinical not-for-profit organization. The opposition procedure, through which any actor is allowed to challenge European patents, was used by geneticists doctors in Europe to refuse the emergence of an industrial monopoly on a medical service offered in a clinical context. The decision to revoke or strongly limit these patents was based on the European Patent Office's refusal to establish an invention priority on a sequence that had errors at the time the application was filed by the patent holder, in September 1994. The patent holder was granted an invention priority only on 24 March 1995, when it filed an application for a corrected sequence of the gene. But by then the BRCA1 gene sequence had already been divulged in a public data base, Genbank, from October 1994, notably by Myriad. Myriad Genetics' patents were thus victims of the patent race that prompted the firm to file multiple patent applications on insufficiently validated sequences, and of the conflict between diffusion in the public domain and the novelty requirement. Opposition to the patents, undertaken by a coalition of medical institutions, human genetic societies, two States, Holland and Austria, an environmental protection organization (Greenpeace), and the Swiss Labour Party, made it possible to preserve and develop the clinical economy of genetic tests in Europe. It resulted in amendments to intellectual property laws in France and thus extended the possibility of using compulsory licences for public health purposes to in vitro diagnosis.

Animals↗
PubMed2005

Academic medical centers' standards for clinical-trial agreements with industry.

BACKGROUND: Although industry sponsors provide approximately 70 percent of the funding for clinical drug trials in the United States, little is known about the legal agreements that exist between industry sponsors and academic investigators. We studied institutional standards regarding contractual provisions that restrict investigators' control over trials. METHODS: We used a structured, cross-sectional mail survey of medical-school research administrators responsible for negotiating clinical-trial agreements with industry sponsors. RESULTS: Of 122 institutions approached, 107 participated. There was a high degree of consensus among administrators about the acceptability of several contractual provisions relating to publications. For example, more than 85 percent reported that their office would not approve provisions giving industry sponsors the authority to revise manuscripts or decide whether results should be published. There was considerable disagreement about the acceptability of provisions allowing the sponsor to insert its own statistical analyses in manuscripts (24 percent allowed them, 47 percent disallowed them, and 29 percent were not sure whether they should allow them), draft the manuscript (50 percent allowed it, 40 percent disallowed it, and 11 percent were not sure whether they should allow it), and prohibit investigators from sharing data with third parties after the trial is over (41 percent allowed it, 34 percent disallowed it, and 24 percent were not sure whether they should allow it). Disputes were common after the agreements had been signed and most frequently centered on payment (75 percent of administrators reported at least one such dispute in the previous year), intellectual property (30 percent), and control of or access to data (17 percent). CONCLUSIONS: Standards for certain restrictive provisions in clinical-trial agreements with industry sponsors vary considerably among academic medical centers. Greater sharing of information about legal relationships with industry sponsors is desirable in order to build consensus about appropriate standards.

Academic Medical Centers↗
PubMed2005

Preparing for pandemic vaccination: an international policy agenda for vaccine development.

The international use of influenza vaccine is growing, especially in developing countries. Since 1997, avian H5N1 influenza in Southeast Asia has caused several human infections and high mortality. Experts warn that the next influenza pandemic is imminent and could be severe. Prevention and control will depend on the rapid production and worldwide distribution of specific pandemic vaccines. If the vaccine supply is to be sufficient to meet global demand, issues related to the intellectual property rights for the reverse genetics technology essential for vaccine production must be resolved. In addition, candidate "pandemic-like" vaccines must be developed and tested in clinical trials to determine the most antigen sparing formulation and the best vaccination schedule. These studies must involve all vaccine companies and will require international coordination and public funding. Whether this international policy agenda for pandemic vaccine development will succeed is uncertain, but it will provide a good indication of whether "good governance" for global public health can be achieved.

Disease Outbreaks↗
PubMed2004

Patents, pills and politics: the Australia-United States Free Trade Agreement and the Pharmaceutical Benefits Scheme.

There is tension between the need of the pharmaceutical innovator for intellectual property protection and the need of society for equitable and affordable access to innovative drugs. The recent Australia-United States Free Trade Agreement provides a nice illustration of this interplay between patents, pills and politics. This article provides a brief history of patent law as applied to pharmaceuticals, describes how the Pharmaceutical Benefits Scheme got caught up in AUSFTA negotiations, analyses the clauses that are likely to impact upon the PBS and describes the political process that reviewed and ultimately amended the AUSFTA.

Australia↗
PubMed1998

Genome projects and gene pools: new germplasm for plant breeding?

Crop gene pools have adapted to and sustained the demands of agricultural systems for thousands of years. Yet, very little is known about their content, distribution, architecture, or circuitry. The presumably shallow elite gene pools often continue to yield genetic gains while the exotic pools remain mostly untapped, uncharacterized, and underutilized. The concept and content of a crop's gene pools are being changed by advancements in plant science and technology. In the first generation of plant genomics, DNA markers have refined some perceptions of genetic variation by providing a glimpse of a primary source, DNA polymorphism. The markers have provided new and more powerful ways of assessing genetic relationships, diversity, and merit by infusing genetic information for the first time in many scenarios or in a more comprehensive manner for others. As a result, crop gene pools may be supplemented through more rapid and directed methods from a greater variety of sources. Previously limited by the barriers of sexual reproduction, the native gene pools will soon be complemented by another gene pool (transgenes) and perhaps by other native exotic gene pools through comparative analyses of plants' biological repertoire. Plant genomics will be an important force of change for crop improvement. The plant science community and crop gene pools may be united and enriched as never before. Also, the genomes and gene pools, the products of evolution and crop domestication, will be reduced and subjected to the vagaries and potential divisiveness of intellectual property considerations. Let the gains begin.

Journal Article↗
PubMed1999

Biotechnology and commodification within health care.

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes.

Biomedical Research↗