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Zehnbauer BA. The Journal of Molecular Diagnostics: 20 Years Defining Professional Practice. J Mol Diagn 2019; 21:938-942. [PMID: 31635797 DOI: 10.1016/j.jmoldx.2019.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 01/09/2023] Open
Abstract
This editorial highlights 20 years of JMD defining professional practice.
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Affiliation(s)
- Barbara A Zehnbauer
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia (Editor-in-Chief).
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2
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Continental drift? Do European clinical genetic testing laboratories have a patent problem? Eur J Hum Genet 2019; 27:997-1007. [PMID: 30846855 PMCID: PMC6777525 DOI: 10.1038/s41431-019-0368-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/14/2018] [Accepted: 01/29/2019] [Indexed: 11/25/2022] Open
Abstract
Recent US Supreme Court decisions have invalidated patent claims on isolated genomic DNA, and testing methods that applied medical correlations using conventional techniques. As a consequence, US genetic testing laboratories have a relatively low risk of infringing patents on naturally occurring DNA or methods for detecting genomic variants. In Europe, however, such claims remain patentable, and European laboratories risk infringing them. We report the results from a survey that collected data on the impact of patents on European genetic testing laboratories. The results indicate that the proportion of European laboratories that have refrained from providing associated testing services owing to patent protection has increased over the last decade (up from 7% in 2008 to 15% in 2017), and that the non-profit sector was particularly strongly affected (up from 4% in 2008 to 14% in 2017). We renew calls for more readily available legal support to help public sector laboratories deal with patent issues, but we do not recommend aligning European law with US law at present. Watchful monitoring is also recommended to ensure that patents do not become a greater hindrance for clinical genetic testing laboratories.
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Nicol D, Dreyfuss RC, Gold ER, Li W, Liddicoat J, Van Overwalle G. International Divergence in Gene Patenting. Annu Rev Genomics Hum Genet 2019; 20:519-541. [PMID: 30786226 DOI: 10.1146/annurev-genom-083118-015112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review explores the recent divergence in international patent law relating to genes and associated subject matter. This divergence stems primarily from decisions of the highest courts in the United States and Australia on the eligibility of patent claims relating to the BRCA gene sequences. Patent offices, courts, and policy makers have struggled for many years to clearly articulate the bounds of patent claims on isolated and synthetic DNA and related products and processes, including methods for their use in genetic diagnostics. This review provides context to the current divergence by mapping key events in the gene patent journey from the early 1980s onward in five key jurisdictions: the United States, the member states of the European Patent Convention, Australia, Canada, and China. Early approaches to gene patenting had some commonalities across jurisdictions, which makes exploration of the recent divergence all the more interesting.There is insufficient empirical evidence to date to confidently predict the consequences of this recent divergence. However, it could potentially have a significant effect on local industry and on consumer access.
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Affiliation(s)
- Dianne Nicol
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart, Tasmania 7001, Australia;
| | - Rochelle C Dreyfuss
- Engelberg Center on Innovation Law and Policy, New York University School of Law, New York, NY 10012, USA
| | - E Richard Gold
- Centre for Intellectual Property Policy, Faculty of Law, McGill University, Montreal, Quebec H3A 1W9, Canada
| | - Wei Li
- School of Law, Zhejiang University of Finance and Economics, Hangzhou, Zhejiang 310018, China
| | - John Liddicoat
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart, Tasmania 7001, Australia; .,Centre for Law, Medicine, and Life Sciences, Faculty of Law, University of Cambridge, Cambridge CB3 9DZ, United Kingdom
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Forsberg EM, Hanssen AB, Nielsen HM, Olesen I. Patent Ethics: The Misalignment of Views Between the Patent System and the Wider Society. SCIENCE AND ENGINEERING ETHICS 2018; 24:1551-1576. [PMID: 28812235 DOI: 10.1007/s11948-017-9956-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
Concerns have been voiced about the ethical implications of patenting practices in the field of biotechnology. Some of these have also been incorporated into regulation, such as the European Commission Directive 98/44 on the legal protection of biotechnological inventions. However, the incorporation of ethically based restrictions into patent legislation has not had the effect of satisfying all concerns. In this article, we will systematically compare the richness of ethical concerns surrounding biotech patenting, with the limited scope of ethical concerns actually addressed in the patent system. As sources of our analyses we will use literature and document studies and a survey with important stakeholders and experts related to Norwegian patenting in the aquacultural biotechnology sector. We will structure the analyses with an ethical matrix, developed for this purpose. Showing the misalignment of the discussions within and outside the patent system, we suggest that an important reason for the ethical controversy still surrounding patenting is that ethical questions keep being framed in a narrow way within the system. Until a richer set of ethical considerations is addressed head-on within the patent system, the patent system will continue to evoke academic and interest group criticism, potentially contributing to a legitimacy crisis of the whole system.
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Affiliation(s)
- Ellen-Marie Forsberg
- Research Group on Responsible Innovation, Work Research Institute, Oslo and Akershus University College, P.O. Box 4, St Olavs Plass, 0130, Oslo, Norway.
| | - Anders Braarud Hanssen
- Research Group on Responsible Innovation, Work Research Institute, Oslo and Akershus University College, P.O. Box 4, St Olavs Plass, 0130, Oslo, Norway
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Affiliation(s)
- Jorge L Contreras
- S. J. Quinney College of Law and Department of Human Genetics, University of Utah, Salt Lake City, UT, USA.
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Sherkow JS, Abbott R. Fortune and hindsight: gene patents' muted effect on medical practice. Br Med Bull 2018; 126:37-45. [PMID: 29608656 DOI: 10.1093/bmb/ldy009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/08/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Physicians have long worried about gene patents' potential to restrict their medical practices. Fortune and hindsight have proven these worries exaggerated both in the UK and elsewhere. Neither current nor future medical practices appear to be impinged by gene patents, although they may be subject to future intellectual property disputes. SOURCES OF DATA Qualitative and quantitative (survey) studies of gene patents' effects on medical practice; recent developments in patent law. AREAS OF AGREEMENT Traditional gene patents do not appear to have restricted medical practice in the UK, although their effect elsewhere has been more nuanced. AREAS OF CONTROVERSY Whether patents will restrict the spread of newer medical technologies is unresolved. AREAS TIMELY FOR DEVELOPING RESEARCH Continuing survey data on practitioners' views concerning patents' role in the distribution of newer technologies would be beneficial.
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Affiliation(s)
- Jacob S Sherkow
- Innovation Center for Law and Technology, New York Law School, 185 West Broadway, New York, NY, USA.,Health Policy and Management, Columbia University Mailman School of Public Health, 722 W. 168th St., New York, NY, USA.,Center for Advanced Studies in Biomedical Innovation Law, University of Copenhagen Faculty of Law, Karen Blixens Plads 16, Copenhagen S, Denmark
| | - Ryan Abbott
- Law and Health Sciences, University of Surrey School of Law, Faculty of Law, Guildford, Surrey, UK.,David Geffen School of Medicine at University of California, 10833 Le Conte Ave, Los Angeles, CA, USA
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Lesser W. Whither the Research Anticommons? INNOVATION, TECHNOLOGY, AND KNOWLEDGE MANAGEMENT 2018. [PMCID: PMC7121752 DOI: 10.1007/978-3-319-67958-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Fifteen years ago, the “tragedy of the anticommons” article warned that excessive patenting of biotech products and research methods could deter rather than stimulate invention, but little evidence was offered. Here, subsequent changes in patent law, public research support, and surveys of researchers are summarized. Results indicate the anticipated anticommons has not materialized significantly, and while ongoing monitoring is warranted, declining public research funding may necessitate more patenting to stimulate private investment.
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Abstract
In genetic diagnostics testing, what are the boundaries of the global patent problem, and is there a real risk that patents and licensing practices could impede access to tests?
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Abstract
The US Supreme Court's recent decision in Association for Molecular Pathology v. Myriad Genetics, Inc. declared, for the first time, that isolated human genes cannot be patented. Many have wondered how genes were ever the subjects of patents. The answer lies in a nuanced understanding of both legal and scientific history. Since the early twentieth century, "products of nature" were not eligible to be patented unless they were "isolated and purified" from their surrounding environment. As molecular biology advanced, and the capability to isolate genes both physically and by sequence came to fruition, researchers (and patent offices) began to apply patent-law logic to genes themselves. These patents, along with other biological patents, generated substantial social and political criticism. Myriad Genetics, a company with patents on BRCA1 and BRCA2, two genes critical to assessing early-onset breast and ovarian cancer risk, and with a particularly controversial business approach, became the antagonist in an ultimately successful campaign to overturn gene patents in court. Despite Myriad's defeat, some questions concerning the rights to monopolize genetic information remain. The history leading to that defeat may be relevant to these future issues.
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Affiliation(s)
- Jacob S Sherkow
- Innovation Center for Law and Technology, New York Law School, New York, NY 10013
| | - Henry T Greely
- Center for Law and the Biosciences, Stanford University, Stanford, CA 94305;
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McHenry KA. BREAST CANCER ACTIVISM IN THE UNITED STATES AND THE POLITICS OF GENES. INTERNATIONAL JOURNAL OF FEMINIST APPROACHES TO BIOETHICS 2015. [DOI: 10.3138/ijfab.8.1.0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Perhaps no other medical advocacy movement has been as successful as breast cancer advocacy in increasing awareness and funds. Recent decades have seen a division between a “green” environmental advocacy aimed at prevention and a “pink” advocacy focused on fund-raising for a cure. The movement has largely failed to address the implications of corporate control over genetic testing, as reflected by the involvement of only one breast cancer organization in the lawsuit against Myriad Genetics Laboratory, which held patents on the BRCA 1/2 genes. This article argues that the reason for this failure is an unwillingness to challenge the role that corporations play in advocacy.
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Hitz A, Prevel Katsanis L. A consumer adoption model for personalized medicine: an exploratory study. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2014. [DOI: 10.1108/ijphm-07-2013-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Purpose
– The purpose of this research is to identify factors linked to the potential acceptance of personalized medicine (PM) by consumers. Roger’s diffusion of innovation model (1995) and the work of Duguay et al. (2003) on transgenic biopharmaceuticals contributed to the development of the proposed conceptual model.
Design/methodology/approach
– The study design was an exploratory cross-sectional survey that used a Canadian national online panel of 307 respondents.
Findings
– The results suggest that the most important factors leading to consumer adoption of PM are knowledge, relative advantage and compatibility with existing values. The level of homophilus traits was negatively related to the acceptance of PM.
Originality/value
– Marketers will need to provide documented evidence of PM’s benefits over existing therapy based on improved efficacy and reduced side effects. Further, concerns about higher price, product distribution and drug reimbursement policies may limit its acceptance. This is the first study to examine the potential adoption and acceptance of PM by consumers.
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Cook-Deegan R, Niehaus A. After Myriad: Genetic Testing in the Wake of Recent Supreme Court Decisions about Gene Patents. CURRENT GENETIC MEDICINE REPORTS 2014; 2:223-241. [PMID: 25401053 PMCID: PMC4225052 DOI: 10.1007/s40142-014-0055-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Genetic testing is becoming more common and more powerful by the day. The costs of the underlying DNA sequencing technology are plummeting, making it likely that tests based on it will become even more pervasive. The use of tests to determine DNA sequence to help make clinical decisions is here to stay. DNA sequencing is also finding new uses in forensics, determination of ancestry, understanding the history and genetic lineages of human populations and many other applications.
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Cartwright-Smith L. Patenting genes: what does Association for Molecular Pathology v. Myriad Genetics mean for genetic testing and research? Public Health Rep 2014; 129:289-92. [PMID: 24790252 DOI: 10.1177/003335491412900311] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Lara Cartwright-Smith
- Lara Cartwright-Smith is an Assistant Research Professor in the Department of Health Policy at The George Washington University School of Public Health and Health Services in Washington, D.C
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Ormond KE, Cho MK. Translating personalized medicine using new genetic technologies in clinical practice: the ethical issues. Per Med 2014; 11:211-222. [PMID: 25221608 PMCID: PMC4160120 DOI: 10.2217/pme.13.104] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The integration of new genetic technologies into clinical practice holds great promise for the personalization of medical care, particularly the use of large-scale DNA sequencing for genome-wide genetic testing. However, these technologies also yield unprecedented amounts of information whose clinical implications are not fully understood, and we are still developing technical standards for measuring sequence accuracy. These technical and clinical challenges raise ethical issues that are similar to but qualitatively different from those that we are accustomed to dealing with for traditional medical genetics. The sheer amount of information afforded by genome sequencing requires rethinking of how to implement core ethical principles including, but not limited to: informed consent, privacy and data ownership and sharing, technology regulation, issues of access, particularly as new technology is integrated into clinical practice, and issues of potential stigma and impact on perceptions of disability. In this article, we will review the issues of informed consent, privacy, data ownership and technology regulation as they relate to the emerging field of personalized medicine and genomics.
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Affiliation(s)
- Kelly E Ormond
- Department of Genetics, Mail Stop-5208, Stanford University, Stanford, CA 94305-5208, USA
- Stanford Center for Biomedical Ethics, 1215 Welch Road, Modular A, Stanford, CA 94305-5417, USA
| | - Mildred K Cho
- Stanford Center for Biomedical Ethics, 1215 Welch Road, Modular A, Stanford, CA 94305-5417, USA
- Department of Pediatrics, 300 Pasteur Drive, Stanford, CA 94305-5208, USA
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16
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Affiliation(s)
- Aaron S Kesselheim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
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Offit K, Bradbury A, Storm C, Merz JF, Noonan KE, Spence R. Gene patents and personalized cancer care: impact of the Myriad case on clinical oncology. J Clin Oncol 2013; 31:2743-8. [PMID: 23766521 PMCID: PMC5795665 DOI: 10.1200/jco.2013.49.7388] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Genomic discoveries have transformed the practice of oncology and cancer prevention. Diagnostic and therapeutic advances based on cancer genomics developed during a time when it was possible to patent genes. A case before the Supreme Court, Association for Molecular Pathology v Myriad Genetics, Inc seeks to overturn patents on isolated genes. Although the outcomes are uncertain, it is suggested here that the Supreme Court decision will have few immediate effects on oncology practice or research but may have more significant long-term impact. The Federal Circuit court has already rejected Myriad's broad diagnostic methods claims, and this is not affected by the Supreme Court decision. Isolated DNA patents were already becoming obsolete on scientific grounds, in an era when human DNA sequence is public knowledge and because modern methods of next-generation sequencing need not involve isolated DNA. The Association for Molecular Pathology v Myriad Supreme Court decision will have limited impact on new drug development, as new drug patents usually involve cellular methods. A nuanced Supreme Court decision acknowledging the scientific distinction between synthetic cDNA and genomic DNA will further mitigate any adverse impact. A Supreme Court decision to include or exclude all types of DNA from patent eligibility could impact future incentives for genomic discovery as well as the future delivery of medical care. Whatever the outcome of this important case, it is important that judicial and legislative actions in this area maximize genomic discovery while also ensuring patients' access to personalized cancer care.
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Affiliation(s)
- Kenneth Offit
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA.
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Cook-Deegan R, Conley JM, Evans JP, Vorhaus D. The next controversy in genetic testing: clinical data as trade secrets? Eur J Hum Genet 2013; 21:585-8. [PMID: 23150081 PMCID: PMC3658186 DOI: 10.1038/ejhg.2012.217] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sole-source business models for genetic testing can create private databases containing information vital to interpreting the clinical significance of human genetic variations. But incomplete access to those databases threatens to impede the clinical interpretation of genomic medicine. National health systems and insurers, regulators, researchers, providers and patients all have a strong interest in ensuring broad access to information about the clinical significance of variants discovered through genetic testing. They can create incentives for sharing data and interpretive algorithms in several ways, including: promoting voluntary sharing; requiring laboratories to share as a condition of payment for or regulatory approval of laboratory services; establishing - and compelling participation in - resources that capture the information needed to interpret the data independent of company policies; and paying for sharing and interpretation in addition to paying for the test itself. US policies have failed to address the data-sharing issue. The entry of new and established firms into the European genetic testing market presents an opportunity to correct this failure.
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Affiliation(s)
- Robert Cook-Deegan
- Institute for Genome Sciences & Policy and Sanford School of Public Policy, Duke University, Durham, NC, USA.
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Caulfield T, Chandrasekharan S, Joly Y, Cook-Deegan R. Harm, hype and evidence: ELSI research and policy guidance. Genome Med 2013; 5:21. [PMID: 23534337 PMCID: PMC3707044 DOI: 10.1186/gm425] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
There has been much investment in research on the ethical, legal and social issues (ELSI) associated with genetic and genomic research. This research should inform the development of the relevant policy. So far, much of the relevant policy - such as in the areas of patents, genetic testing and genetic discrimination - seems to be informed more by speculation of harm and anecdote than by available evidence. Although a quest for evidence cannot always be allowed to delay policy choice, it seems axiomatic to us that policy options are improved by the incorporation of evidence.
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Affiliation(s)
- Timothy Caulfield
- Health Law and Science Policy Group, University of Alberta, Edmonton, Alberta Canada, T6G 2H5
| | - Subhashini Chandrasekharan
- Institute for Genome Sciences and Policy, North Building, Duke University, USA Drive, Box 90141 Durham, NC 27708, USA
| | - Yann Joly
- Department of Human Genetics, McGill University, 740 Dr. Penfield Avenue, Montreal, Quebec, Canada, H3A 0G1
| | - Robert Cook-Deegan
- Institute for Genome Sciences and Policy, North Building, Duke University, USA Drive, Box 90141 Durham, NC 27708, USA
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Baldwin AL, Cook-Deegan R. Constructing narratives of heroism and villainy: case study of Myriad's BRACAnalysis(®) compared to Genentech's Herceptin(®). Genome Med 2013; 5:8. [PMID: 23369278 PMCID: PMC3707051 DOI: 10.1186/gm412] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 12/19/2012] [Accepted: 01/31/2013] [Indexed: 11/23/2022] Open
Abstract
Background The development of Herceptin® is welcomed as a major advance in breast cancer treatment, while Myriad's development of BRACAnalysis® is a widely used diagnostic. However useful and successful this product is, its presence in the public eye is tainted by predominantly negative press about gene patenting and business practices. Discussion While retrospection invites a sharp contrast between Genentech's triumphal narrative of scientific achievement and Myriad's public image as a controversial monopolist, a comparative history of these companies' products reveals two striking consistencies: patents and public discontent. Despite these similarities, time has reduced the narrative to that of hero versus villain: Genentech is lauded - at least for the final outcome of the Herceptin® story - as a corporate good citizen, Myriad as a ruthless mercenary. Since patents undergird both products yet the narratives are so different, the stories raise the question: why have patents taken the fall as the scapegoat in current biotechnology policy debate? Summary A widely publicized lawsuit and accompanying bad press have cast Myriad as a villain in the evolving narrative of biotechnology. While the lawsuit suggests that this villainy is attributable to Myriad's intellectual property, we suggest through a comparative case study that, at least in the Myriad case, it is not simply about the patents but also other business strategies the company chose to pursue. Patents were a necessary but not sufficient cause of controversy.
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Affiliation(s)
- A Lane Baldwin
- Genome Ethics, Law & Policy, Institute for Genome Sciences & Policy, Duke University, Box 90141, 304 Research Drive, Durham, NC 27708-0141, USA
| | - Robert Cook-Deegan
- Genome Ethics, Law & Policy, Institute for Genome Sciences & Policy, Duke University, Box 90141, 304 Research Drive, Durham, NC 27708-0141, USA
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Abstract
Restrictive patenting and licensing for cell-free fetal DNA testing has serious consequences for technology advances and benefits to public health.
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Affiliation(s)
- Lauren C Sayres
- Stanford Center for Biomedical Ethics, Stanford University, Stanford, CA 94301, USA.
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Sayres LC, Allyse M, Cho MK. Integrating stakeholder perspectives into the translation of cell-free fetal DNA testing for aneuploidy. Genome Med 2012; 4:49. [PMID: 22720727 PMCID: PMC3738226 DOI: 10.1186/gm348] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 05/23/2012] [Accepted: 06/21/2012] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The translation of novel genomic technologies from bench to bedside enjoins the comprehensive consideration of the perspectives of all stakeholders who stand to influence, or be influenced by, the translational course. Non-invasive prenatal aneuploidy testing that utilizes cell-free fetal DNA (cffDNA) circulating in maternal blood is one example of an innovative technology that promises significant benefits for its intended end users; however, it is currently uncertain whether it will achieve widespread clinical implementation. We conducted qualitative interviews with 18 diverse stakeholders in this domain, including prospective users of the technology and healthcare personnel, researchers and developers, and experts in social, legal, and regulatory aspects of genetic technology, and a pilot survey of 62 obstetric healthcare providers. Analysis of interview and survey data was combined with a review of the proceedings of a full-day, multidisciplinary conference on the topic and published scientific and ethics literature surrounding this and other relevant technologies. DISCUSSION We constructed potential pathways for technological implementation, identified broad stakeholder classes party to these translational processes, and performed a preliminary assessment of the viewpoints and interrelations among these diverse stakeholders. Some of the stakeholders whose priorities are critical to understand and integrate into translation include pregnant women and their families; healthcare providers; scientists, their institutions or companies, and the funding agencies that support them; regulatory and judicial bodies; third-party payers; professional societies; educational systems; disability rights communities; and other representatives from civil society. Stakeholder interviews, survey findings, and conference proceedings add complexity to these envisioned pathways and also demonstrate a paramount need to incorporate an iterative stakeholder analysis early and throughout the translational endeavor. We believe that the translational framework that we have developed will help guide crucial future stakeholder mapping and engagement activities for cffDNA aneuploidy testing and inform novel methods of technology assessment for other developments in the growing field of genomic medicine. SUMMARY Mapping potential pathways for implementation and exploring the attitudes and interrelations of diverse stakeholders may lead to more effective translation of a novel method of prenatal aneuploidy testing.
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Affiliation(s)
- Lauren C Sayres
- Stanford Center for Biomedical Ethics, Stanford University, 1215 Welch Road Modular A, Stanford, California, 94301, USA
| | - Megan Allyse
- Stanford Center for Biomedical Ethics, Stanford University, 1215 Welch Road Modular A, Stanford, California, 94301, USA
| | - Mildred K Cho
- Stanford Center for Biomedical Ethics, Stanford University, 1215 Welch Road Modular A, Stanford, California, 94301, USA ; Department of Pediatrics, Division of Genetics, Stanford University, 1215 Welch Road Modular A, Stanford, California, 94301, USA
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Hopkins MM, Hogarth S. Biomarker patents for diagnostics: problem or solution? Nat Biotechnol 2012; 30:498-500. [PMID: 22678384 DOI: 10.1038/nbt.2257] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Michael M Hopkins
- SPRU: Science and Technology Policy Research, University of Sussex, Brighton, UK.
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Abstract
Since the 1970s, patents on human genes and genetic diagnostic methods have been granted under the assumption that they stimulate the development of diagnostic methods and therapeutic products. However, the principles and practices of patenting vary between jurisdictions. Do patent holders, researchers, clinicians and patients really benefit from this heterogeneous patent system? We discuss the problems that result from the current system and suggest how they might be solved by altering the way in which patents are granted and/or licensed.
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Klein RD. Gene patents and personalized medicine. Am Soc Clin Oncol Educ Book 2012:81-83. [PMID: 24451713 DOI: 10.14694/edbook_am.2012.32.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The use of genetic information to design and guide therapies and to develop novel diagnostic procedures creates important patent issues. Patents on human gene sequences have likely helped stimulate the introduction of new biologics; however, their role and that of patents on genotype-phenotype correlations in diagnostic testing is highly controversial. Genotype-phenotype associations are at the heart of personalized medicine. The intellectual property rules by which these biologic relationships are governed have profound implications for the growth of individualized medicine.
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Affiliation(s)
- Roger D Klein
- From the Medical College of Wisconsin, Milwaukee, WI
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26
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Berthels N, Matthijs G, Van Overwalle G. Impact of gene patents on diagnostic testing: a new patent landscaping method applied to spinocerebellar ataxia. Eur J Hum Genet 2011; 19:1114-21. [PMID: 21811306 PMCID: PMC3198141 DOI: 10.1038/ejhg.2011.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 04/13/2011] [Accepted: 05/11/2011] [Indexed: 11/08/2022] Open
Abstract
Recent reports in Europe and the United States raise concern about the potential negative impact of gene patents on the freedom to operate of diagnosticians and on the access of patients to genetic diagnostic services. Patents, historically seen as legal instruments to trigger innovation, could cause undesired side effects in the public health domain. Clear empirical evidence on the alleged hindering effect of gene patents is still scarce. We therefore developed a patent categorization method to determine which gene patents could indeed be problematic. The method is applied to patents relevant for genetic testing of spinocerebellar ataxia (SCA). The SCA test is probably the most widely used DNA test in (adult) neurology, as well as one of the most challenging due to the heterogeneity of the disease. Typically tested as a gene panel covering the five common SCA subtypes, we show that the patenting of SCA genes and testing methods and the associated licensing conditions could have far-reaching consequences on legitimate access to this gene panel. Moreover, with genetic testing being increasingly standardized, simply ignoring patents is unlikely to hold out indefinitely. This paper aims to differentiate among so-called 'gene patents' by lifting out the truly problematic ones. In doing so, awareness is raised among all stakeholders in the genetic diagnostics field who are not necessarily familiar with the ins and outs of patenting and licensing.
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Affiliation(s)
- Nele Berthels
- Centre for Intellectual Property Rights, Faculty of Law, University of Leuven, Leuven, Belgium
| | - Gert Matthijs
- Centre for Human Genetics, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Geertrui Van Overwalle
- Centre for Intellectual Property Rights, Faculty of Law, University of Leuven, Leuven, Belgium
- Tilburg Institute for Law, Technology and Society, Faculty of Law, Tilburg University, Tilburg, The Netherlands
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Affiliation(s)
- Timothy Caulfield
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada.
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Toneguzzo F. Impact of gene patents on the development of molecular diagnostics. ACTA ACUST UNITED AC 2011; 5:273-6. [PMID: 23484548 DOI: 10.1517/17530059.2011.575059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is a widely held view that gene patents in particular and patents in general, because of the exclusionary rights that they provide, are inhibiting the development of and access to critical molecular diagnostic testing. This is a highly relevant issue for healthcare delivery as we move towards personalized medicine, which relies heavily on genetic testing to tailor treatments that are specific for individual characteristics. Critics of the patent system hope to void or diminish the exclusionary aspect of patents by removing genes from the definition of what is patentable, by increasing the number of activities that fall within the research use exemption, or by compelling patent holders to license their rights non-exclusively. Although a re-examination of what constitutes patentable subject matter is an important undertaking, narrowing the definition of patentable subject matter is at best only a partial solution. Erosion of the patent system through compulsory licensing or expansion of the research use exemption runs the risk of destroying important incentives without also fully addressing the problem. To promote solutions that truly address the issues, this article distinguishes documented facts from perceptions and suggests alternative approaches to explore. The author believes that efforts to undermine the patent system are simply counterproductive and that time would be better spent addressing the real issues that lie within molecular diagnostic development.
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Affiliation(s)
- Frances Toneguzzo
- Research Ventures and Licensing, Partners HealthCare, 101 Huntington Ave, Fourth Floor, Boston, MA 01864 , USA
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29
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Powers JB, Campbell EG. Technology Commercialization Effects on the Conduct of Research in Higher Education. RESEARCH IN HIGHER EDUCATION 2011; 52:245-260. [PMID: 22427717 PMCID: PMC3305807 DOI: 10.1007/s11162-010-9195-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The objective of this study was to investigate the effects of technology commercialization on researcher practice and productivity at U.S. universities. Using data drawn from licensing contract documents and databases of university-industry linkages and faculty research output, the study findings suggest that the common practice of licensing technologies exclusively to singular firms may have a dampening effect on faculty inventor propensity to conduct published research and to collaborate with others on research. Furthermore, faculty who are more actively engaged in patenting may be less likely to collaborate with outsiders on research while faculty at public universities may experience particularly strong norms to engage in commercialization vis-à-vis traditional routes to research dissemination. These circumstances appear to be hindering innovation via the traditional mechanisms (research publication and collaboration), questioning the success of policymaking to date for the purpose of speeding the movement of research from the lab bench to society.
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Affiliation(s)
- Joshua B Powers
- Department of Educational Leadership, Indiana State University, Terre Haute, Indiana
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Becker F, van El CG, Ibarreta D, Zika E, Hogarth S, Borry P, Cambon-Thomsen A, Cassiman JJ, Evers-Kiebooms G, Hodgson S, Janssens ACJW, Kaariainen H, Krawczak M, Kristoffersson U, Lubinski J, Patch C, Penchaszadeh VB, Read A, Rogowski W, Sequeiros J, Tranebjaerg L, van Langen IM, Wallace H, Zimmern R, Schmidtke J, Cornel MC. Genetic testing and common disorders in a public health framework: how to assess relevance and possibilities. Background Document to the ESHG recommendations on genetic testing and common disorders. Eur J Hum Genet 2011; 19 Suppl 1:S6-44. [PMID: 21412252 PMCID: PMC3327518 DOI: 10.1038/ejhg.2010.249] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Frauke Becker
- Hannover Medical School, Department of Human Genetics, Hannover, Germany
| | - Carla G van El
- Department of Clinical Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dolores Ibarreta
- IPTS Institute for Prospective Technological Studies, Joint Research Centre, European Commission, Seville, Spain
| | - Eleni Zika
- IPTS Institute for Prospective Technological Studies, Joint Research Centre, European Commission, Seville, Spain
| | - Stuart Hogarth
- Department of Social Sciences, Loughborough University, Loughborough, UK
| | - Pascal Borry
- Department of Clinical Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Centre for Biomedical Ethics and Law, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Medical Humanities and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Anne Cambon-Thomsen
- Inserm, U 558, Department of Epidemiology, Health Economics and Public Health, University Paul Sabatier, Toulouse, France
| | | | - Gerry Evers-Kiebooms
- Psychosocial Genetics Unit University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Shirley Hodgson
- Department of Clinical Genetics, St George's University of London, London, UK
| | - A Cécile J W Janssens
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Christian-Albrechts-Universität, Kiel, Germany
| | | | - Jan Lubinski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Andrew Read
- Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | - Wolf Rogowski
- Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians University, Munich, Germany
| | - Jorge Sequeiros
- IBMC – Institute for Molecular and Cell Biology, and ICBAS, University of Porto, Porto, Portugal
| | - Lisbeth Tranebjaerg
- Department of Audiology, H:S Bispebjerg Hospital and Wilhelm Johannsen Centre of Functional Genomics, University of Copenhagen, Copenhagen, Denmark
| | - Irene M van Langen
- Department of Genetics, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Helen Wallace
- GeneWatch UK, The Mill House, Tideswell, Derbyshire, UK
| | - Ron Zimmern
- PHG Foundation, Worts Causeway, Cambridge, UK
| | - Jörg Schmidtke
- Hannover Medical School, Department of Human Genetics, Hannover, Germany
| | - Martina C Cornel
- Department of Clinical Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Cho M. Patently unpatentable: implications of the Myriad court decision on genetic diagnostics. Trends Biotechnol 2011; 28:548-51. [PMID: 20832881 DOI: 10.1016/j.tibtech.2010.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Revised: 08/03/2010] [Accepted: 08/13/2010] [Indexed: 10/19/2022]
Abstract
The recent decision in the case Association for Molecular Pathology et al. v. United States Patent and Trademark Office et al. shocked the biotechnology industry. Although the case could be overturned on appeal, it will probably change how gene patents are written. The effects of the decision might be most strongly felt in the short term by clinical laboratories that develop new genetic tests based on single genes. However, evidence suggests that patents are less effective as an incentive to innovate in the field of genetic diagnostics than for pharmaceuticals. In addition, as genomic technologies move towards whole-genome analysis, policy arguments for patent protection for single genes become less compelling. It is clear that the intellectual property model challenged by the Myriad decision will have to be replaced if new genetic technologies are to achieve their full potential in promoting 'the progress of science and useful arts'.
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Affiliation(s)
- Mildred Cho
- Stanford Center for Biomedical Ethics, 1215 Welch Road, Stanford, CA 94305, USA.
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32
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33
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Paci D, Hopkins MM, Zika E, Ibarreta D. Impact of DNA patents on pharmacogenomics research and development: economic and policy issues. Drug Dev Res 2010. [DOI: 10.1002/ddr.20419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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34
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35
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Kumar MN. Ethical Conflicts in Commercialization of University Research in the Post–Bayh–Dole Era. ETHICS & BEHAVIOR 2010. [DOI: 10.1080/10508422.2010.491759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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36
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Reply to Waking up and smelling the coffee. Nat Biotechnol 2010. [DOI: 10.1038/nbt0810-779a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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37
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Carbone J, Gold ER, Sampat B, Chandrasekharan S, Knowles L, Angrist M, Cook-Deegan R. DNA patents and diagnostics: not a pretty picture. Nat Biotechnol 2010; 28:784-91. [PMID: 20697400 PMCID: PMC3026778 DOI: 10.1038/nbt0810-784] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Julia Carbone
- Duke University's School of Law, Durham, North Carolina, USA
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38
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Abstract
From the late 1980s, a storm surrounding the wisdom, ethics, and economics of human gene patents has been brewing. The various winds of concern in this storm touched on the impact of gene patents on basic and clinical research, on health care delivery, and on the ability of public health care systems to provide equal access when faced with costly patented genetic diagnostic tests. Myriad Genetics, Inc., along with its subsidiary, Myriad Genetic Laboratories, Inc., a small Utah-based biotechnology company, found itself unwittingly in the eye of this storm after a series of decisions it made regarding the commercialization of a hereditary breast cancer diagnostic test. This case study examine the background to Myriad's decisions, the context in which these decisions were made and the policy, research and business response to them.
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Spinocerebellar ataxia: patient and health professional perspectives on whether and how patents affect access to clinical genetic testing. Genet Med 2010; 12:S83-S110. [PMID: 20393313 DOI: 10.1097/gim.0b013e3181d67e44] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Genetic testing for spinocerebellar ataxia is used in diagnosis of rare movement disorders. Such testing generally does not affect treatment, but confirmation of mutations in a known gene can confirm diagnosis and end an often years-long quest for the cause of distressing and disabling symptoms. Through interviews and a web forum hosted by the National Ataxia Foundation, patients and health professionals related their experiences with the effect of patents on access to genetic testing for spinocerebellar ataxia. In the United States, Athena Diagnostics holds either a patent or an exclusive license to a patent in the case of six spinocerebellar ataxia variants (spinocerebellar ataxia 1-3 and 6-8) and two other hereditary ataxias (Friedreich's Ataxia and Early Onset Ataxia). Athena has enforced its exclusive rights to spinocerebellar ataxia-related patents by sending notification letters to multiple laboratories offering genetic testing for inherited neurological conditions, including spinocerebellar ataxia. Roughly half of web forum respondents had decided not to get genetic tests. Price, coverage and reimbursement by insurers and health plans, and fear of genetic discrimination were the main reasons cited for deciding not to get tested. Price was cited as an access concern by the physicians, and as sole US provider, coverage and reimbursement depend on having payment agreements between Athena and payers. In cases in which payers do not reimburse, the patient is responsible for payment, although some patients can apply to the voluntary Athena Access and Patient Protection Plan offered by the company.
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40
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Williams HL. Intellectual property rights and innovation: Evidence from the human genome. THE JOURNAL OF POLITICAL ECONOMY 2010; 121:1-27. [PMID: 24639594 PMCID: PMC3955392 DOI: 10.1086/669706] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Do intellectual property (IP) rights on existing technologies hinder subsequent innovation? Using newly-collected data on the sequencing of the human genome by the public Human Genome Project and the private firm Celera, this paper estimates the impact of Celera's gene-level IP on subsequent scientific research and product development. Genes initially sequenced by Celera were held with IP for up to two years, but moved into the public domain once re-sequenced by the public effort. Across a range of empirical specifications, I find evidence that Celera's IP led to reductions in subsequent scientific research and product development on the order of 20 to 30 percent. Taken together, these results suggest that Celera's short-term IP had persistent negative effects on subsequent innovation relative to a counterfactual of Celera genes having always been in the public domain.
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41
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Mann KP. Gene patents: perspectives from the clinical laboratory. Mol Diagn Ther 2010; 14:137-40. [PMID: 20560674 DOI: 10.2165/11538420-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Patents involving human genes, human genetic material, and genotype-phenotype correlations are a reality and are increasingly having a negative effect on the clinical molecular diagnostic laboratory and on patient care. Specifically, gene patents and exclusive licensing of diagnostic testing has a detrimental effect on the quality of laboratory testing, the cost of testing, turnaround time, coordination of care, patient access to testing and the ability to confirm testing at a separate laboratory. In this article, gene patents are discussed from the perspective of a medical director of a molecular diagnostics laboratory, and the effect of such patents on clinical laboratory practice is examined.
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Affiliation(s)
- Karen P Mann
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
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42
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43
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Legal developments and practical implications of gene patenting on targeted drug discovery and development. Clin Pharmacol Ther 2010; 87:633-5. [PMID: 20485317 DOI: 10.1038/clpt.2010.47] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The use of genetic information to design and guide therapies creates novel patent issues. Gene patents have been integral to the introduction of new biologics, but their role in diagnostic testing is controversial. Genotype-phenotype associations are at the heart of personalized medicine. The intellectual property rules by which these biological relationships are governed have profound implications for the growth of this field. Several cases currently before the courts may add reason and clarity to the law in this area.
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Cook-Deegan R, DeRienzo C, Carbone J, Chandrasekharan S, Heaney C, Conover C. Impact of gene patents and licensing practices on access to genetic testing for inherited susceptibility to cancer: comparing breast and ovarian cancers with colon cancers. Genet Med 2010; 12:S15-38. [PMID: 20393305 PMCID: PMC3047448 DOI: 10.1097/gim.0b013e3181d5a67b] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Genetic testing for inherited susceptibility to breast and ovarian cancer can be compared with similar testing for colorectal cancer as a "natural experiment." Inherited susceptibility accounts for a similar fraction of both cancers and genetic testing results guide decisions about options for prophylactic surgery in both sets of conditions. One major difference is that in the United States, Myriad Genetics is the sole provider of genetic testing, because it has sole control of relevant patents for BRCA1 and BRCA2 genes, whereas genetic testing for familial colorectal cancer is available from multiple laboratories. Colorectal cancer-associated genes are also patented, but they have been nonexclusively licensed. Prices for BRCA1 and 2 testing do not reflect an obvious price premium attributable to exclusive patent rights compared with colorectal cancer testing, and indeed, Myriad's per unit costs are somewhat lower for BRCA1/2 testing than testing for colorectal cancer susceptibility. Myriad has not enforced patents against basic research and negotiated a Memorandum of Understanding with the National Cancer Institute in 1999 for institutional BRCA testing in clinical research. The main impact of patenting and licensing in BRCA compared with colorectal cancer is the business model of genetic testing, with a sole provider for BRCA and multiple laboratories for colorectal cancer genetic testing. Myriad's sole-provider model has not worked in jurisdictions outside the United States, largely because of differences in breadth of patent protection, responses of government health services, and difficulty in patent enforcement.
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Affiliation(s)
- Robert Cook-Deegan
- Center for Public Genomics, Center for Genome Ethics, Law and Policy, Institute for Genome Sciences and Policy, Duke University, Durham, NC 27708, USA.
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46
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Colaianni A, Chandrasekharan S, Cook-Deegan R. Impact of gene patents and licensing practices on access to genetic testing and carrier screening for Tay-Sachs and Canavan disease. Genet Med 2010; 12:S5-S14. [PMID: 20393311 PMCID: PMC3042321 DOI: 10.1097/gim.0b013e3181d5a669] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Genetic testing for Tay-Sachs and Canavan disease is particularly important for Ashkenazi Jews, because both conditions are more frequent in that population. This comparative case study was possible because of different patenting and licensing practices. The role of DNA testing differs between Tay-Sachs and Canavan diseases. The first-line screening test for Tay-Sachs remains an enzyme activity test rather than genotyping. Genotyping is used for preimplantation diagnosis and confirmatory testing. In contrast, DNA-based testing is the basis for Canavan screening and diagnosis. The HEXA gene for Tay-Sachs was cloned at the National Institutes of Health, and the gene was patented but has not been licensed. The ASPA gene for Canavan disease was cloned and patented by Miami Children's Hospital. Miami Children's Hospital did not inform family members and patient groups that had contributed to the gene discovery that it was applying for a patent, and pursued restrictive licensing practices when a patent issued in 1997. This led to intense controversy, litigation, and a sealed, nonpublic 2003 settlement that apparently allowed for nonexclusive licensing. A survey of laboratories revealed a possible price premium for ASPA testing, with per-unit costs higher than for other genetic tests in the Secretary's Advisory Committee on Genetics, Health, and Society case studies. The main conclusion from comparing genetic testing for Tay-Sachs and Canavan diseases, however, is that patenting and licensing conducted without communication with patients and advocates cause mistrust and can lead to controversy and litigation, a negative model to contrast with the positive model of patenting and licensing for genetic testing of cystic fibrosis.
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Affiliation(s)
- Alessandra Colaianni
- Center for Public Genomics, Center for Genome Ethics, Law & Policy, Institute for Genome Sciences & Policy, Duke University, Durham, NC 27708, USA
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47
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Skeehan K, Heaney C, Cook-Deegan R. Impact of gene patents and licensing practices on access to genetic testing for Alzheimer disease. Genet Med 2010; 12:S71-82. [PMID: 20393312 PMCID: PMC2913132 DOI: 10.1097/gim.0b013e3181d5a68e] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Genetic testing for Alzheimer disease includes genotyping for apolipoprotein E, for late-onset Alzheimer disease, and three rare autosomal dominant, early-onset forms of Alzheimer disease associated with different genes (APP, PSEN1, and PSEN2). According to researchers, patents have not impeded research in the field, nor were patents an important consideration in the quest for the genetic risk factors. Athena Diagnostics holds exclusive licenses from Duke University for three "method" patents covering apolipoprotein E genetic testing. Athena offers tests for apolipoprotein E and genes associated with early-onset, autosomal-dominant Alzheimer disease. One of those presenilin genes is patented and exclusively licensed to Athena; the other presenilin gene was patented but the patent was allowed to lapse; and one (amyloid precursor protein) is patented as a research tool. Direct-to-consumer testing is available for some Alzheimer disease-related genes, apparently without a license. Athena Diagnostics consolidated its position in the market for Alzheimer disease genetic testing by collecting exclusive rights to patents arising from university research. Duke University also used its licenses to Athena to enforce adherence to clinical guidelines, including elimination of the service from Smart Genetics, which was offering direct-to-consumer risk assessment based on apolipoprotein E genotyping.
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Affiliation(s)
- Katie Skeehan
- Center for Public Genomics, Center for Genome Ethics, Law and Policy, Institute for Genome Sciences and Policy, Duke University, Durham, NC 27708, USA
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48
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Mann KP. Gene patents: a view from the clinical laboratory. Expert Rev Mol Diagn 2010; 10:123-5. [DOI: 10.1586/erm.09.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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49
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Huys I, Berthels N, Matthijs G, Van Overwalle G. Legal uncertainty in the area of genetic diagnostic testing. Nat Biotechnol 2010; 27:903-9. [PMID: 19816443 DOI: 10.1038/nbt1009-903] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A patent landscape analysis of 22 common genetic diagnostic tests shows substantially fewer claims on genes per se than initially suggested but raises questions of legal uncertainty as to the claims' scope.
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Affiliation(s)
- Isabelle Huys
- Centre for Intellectual Property Rights, Faculty of Law, Catholic University of Leuven, Leuven, Belgium
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50
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Abstract
Genomics and human genetics are scientifically fundamental and commercially valuable. These fields grew to prominence in an era of growth in government and nonprofit research funding, and of even greater growth of privately funded research and development in biotechnology and pharmaceuticals. Patents on DNA technologies are a central feature of this story, illustrating how patent law adapts-and sometimes fails to adapt-to emerging genomic technologies. In instrumentation and for therapeutic proteins, patents have largely played their traditional role of inducing investment in engineering and product development, including expensive post-discovery clinical research to prove safety and efficacy. Patents on methods and DNA sequences relevant to clinical genetic testing show less evidence of benefits and more evidence of problems and impediments, largely attributable to university exclusive licensing practices. Whole-genome sequencing will confront uncertainty about infringing granted patents, but jurisprudence trends away from upholding the broadest and potentially most troublesome patent claims.
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Affiliation(s)
- Robert Cook-Deegan
- Institute for Genome Sciences and Policy, Duke University, Durham, NC 27708, USA.
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