Author

E.K. Tetteh

Abstract

Concerns about increasing expenditures on new biologic medicines has speared interests in finding solutions to contain healthcare delivery costs whilst, at least, maintaining population health indicators at the same levels. Often overlooked are investments in pharmaceutical manufacturing research, which perhaps is because manufacturing costs are thought to only make a small fraction of drug prices, and hence any impact on healthcare delivery costs is small enough to be ignored. This thesis provides evidence, to the contrary, that the impact on healthcare delivery costs cannot be trivialized. Starting with a systematic review of literature, this thesis finds that there are inconsistencies in what items are included or excluded from estimates of drug administration costs. On the back of this finding, this thesis evaluated drug administration costs for a sample of biologic drugs to identify manufacturing choices that explain most the observed variation in administration costs. It presents an algorithm pharmaceutical manufacturers could use to predict the expected administration-cost savings from reformulating biologic drug candidates still in development and/or existing medicines already on the market. This thesis goes further to argue that a primary focus on the monetary costs of drug administration ignores intangible benefits from satisfying end-user preferences for different modes of drug administration. The monetary value of these intangible benefits could be in the same order of magnitude as savings on the direct monetary costs of drug administration. In addition, this thesis shows that using cost-reducing process innovations in drug manufacturing, as opposed to cost-increasing ones, is associated with a higher number of products available for clinical use and lower prices over time; whilst the likelihood that a drug product is no longer available is seemingly unrelated to the process innovation deployed in manufacturing. The evidence put together indicate significant societal benefits from developing and implementing innovations in pharmaceutical manufacturing.