Selecting incentive interventions to encourage pharmaceutical research and development for neglected diseases: A decision-support framework
| dc.contributor.advisor | Bam, Louzanne | en_ZA |
| dc.contributor.advisor | De Kock, Imke | en_ZA |
| dc.contributor.advisor | Vandaele, Nico Johan | en_ZA |
| dc.contributor.author | Hanekom, Nicola | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering. | en_ZA |
| dc.date.accessioned | 2021-10-07T05:15:39Z | |
| dc.date.accessioned | 2021-12-22T14:15:31Z | |
| dc.date.available | 2021-10-07T05:15:39Z | |
| dc.date.available | 2021-12-22T14:15:31Z | |
| dc.date.issued | 2021-12 | |
| dc.description | Thesis (PhD)--Stellenbosch University, 2021. | en_ZA |
| dc.description.abstract | ENGLISH ABSTRACT: Neglected diseases are diseases for which adequate drug treatment is lacking or not commonly available to sufferers of the disease. The diseases mostly affect people living in developing countries with more than one billion people globally affected by some of the ‘most neglected diseases’, known as neglected tropical diseases. Central to understanding the phenomenon of neglected diseases is the concept of market attractiveness, which refers to perceived market potential. As the multinational drug industry is highly competitive, it delivers drugs based on economic market forces. From the perspective of both public- and private investors, the market for neglected diseases is not sufficiently attractive to attain the necessary resources to effectively address such diseases. Noteworthy effort has been devoted to encouraging pharmaceutical organizations, non-profit organizations, and governments to engage in the research and development (R&D) for neglected diseases. Incentive interventions are a method used to promote these research efforts. Incentives aim to mitigate the challenges of completing drug R&D, by providing some kind of benefit or reward. A significant number of incentive interventions has been proposed and/or implemented for improving neglected disease research. Given the number of incentive strategies and types that exist, difficulty occurs in selecting an incentive intervention that is appropriate for encouraging R&D for the specific pharmaceutical landscape, the stakeholders that are involved, and the health care system context. This research proposes a decision-support framework that intends to assist any governmental, private or public entity aiming to encourage investment in the R&D of drugs for a disease that is currently experiencing neglect, with the selection of an appropriate incentive intervention. This is done by investigating literature on the goals and outcomes of health care systems, completing a pharmaceutical R&D market analysis, systematically reviewing literature on diseases that are perceived as being neglected and or attractive to pharmaceutical organizations, and investigating existing incentive interventions. The decision-support framework outcome provides a shortlisted set of recommended solutions (incentivising interventions) based on (i) the current pharmaceutical research and development system being addressed; (ii) the needs, abilities, and limitations of the enabling organization or body; the (iii) needs and objectives of the innovating organizations and the end-users (both the consumers and the procurers of drugs); and (iv) the abilities of the incentivizing interventions to address the priority improvement areas of the scenario under investigation. Through a verification and validation process involving subject matter experts and the application of three retrospective case studies, the decision-support framework is deemed a comprehensive and valuable contribution to assist in the selection of an appropriate set of incentive-based interventions. The framework thus contributes towards effective and efficient resource allocation in the context of the global neglected diseases R&D sphere. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Verwaarloosde siektes is siektes waarvoor voldoende farmaseutiese-behandeling ontbreek of nie algemeen beskikbaar is aan lyers van die siekte nie. Hoofsaaklik mense wat in ontwikkelende lande woon word deur hierdie siektes geraak, met meer as een miljard mense wat wêreldwyd geraak word deur sommige van die ‘mees verwaarloosde siektes', bekend as verwaarloosde tropiese siektes. Die konsep van aantreklikheid van die mark, wat verwys na die waargenome markpotensiaal, is ‘n kernbegrip om die verskynsel van verwaarloosde siektes te verstaan. Gegewe dat die multinasionale farmaseutiesebedryf uiters mededingend is, lewer dit medisyne op grond van ekonomiese markkragte. Vanuit openbare-sektor- sowel as privaat-sektor beleggers se perspektief, is die mark vir verwaarloosde siektes nie voldoende aantreklik om die nodige hulpbronne te verkry om hierdie siektes aan te spreek nie. Beduidende pogings is aangewend om farmaseutiese organisasies, organisasies sonder winsoogmerk en regerings aan te moedig om deel te neem aan die navorsing en ontwikkeling (N&O) van medikasie vir verwaarloosde siektes. Aansporingsintervensies is 'n metode wat gebruik word om hierdie navorsingspogings te bevorder. Aansporings poog om die uitdagings wat met N&O gepaardgaan te verlig deur ‘n voordeel of beloning aan te bied. ‘n Beduidende aantal aansporingsintervensies is voorgestel en/of geïmplementeer om navorsing oor verwaarloosde siektes te verbeter. Gegewe die aantal aansporingstrategieë wat bestaan, is dit moeilik om 'n aansporingsintervensie te identifiseer wat gepas is vir: ‘n spesifieke farmaseutiese landskap; die betrokkenes; en die gesondheidsorgsisteem-konteks. Hierdie navorsing stel 'n besluitsteunraamwerk voor, wat bedoel is om enige regerings-, privaat- of openbare entiteit te help met die die keuse van 'n gepaste aansporingsintervensie om sodoende belegging in die N&O van medisyne aan te moedig vir 'n siekte wat tans verwaarloos is. Dit word gedoen deur literatuur te ondersoek aangaande doelstellings en uitkomste van gesondheidsorgstelsels, 'n farmaseutiese N&O-marksanaliese te voltooi, ’n stelselmatige oorsig oor literatuur aangaande siektes wat beskou word as verwaarloos en/of aantreklik vir farmaseutiese organisasies voor te lê, asook bestaande aansporingsintervensies te ondersoek. Die uitkoms van die besluitsteunraamwerk is 'n kortlys met aanbevole oplossings (aansporende intervensies). Die kortlys word bepaal na gelang van (i) die eienskappe farmaseutiese N&O-stelsel wat aangespreek word; (ii) die behoeftes, vermoëns en beperkings van die instaatstellende organisasie of liggaam; en (iii) die vermoëns van die aansporende intervensies om die prioriteitsareas van die scenario wat ondersoek word, aan te spreek. Na gelang van 'n verifiërings- en valideringsproses wat vakkundiges betrek, word die besluitsteunraamwerk beskou as 'n omvattende en waardevolle bydrae tot die identifisering van gepasde aansporingsintervensies ter bevordering van ‘n verhoging in die hulpbronne wat wêreldwyd aan N&O van medikasie vir verwaarloosde siektes gewy word. | af_ZA |
| dc.description.version | Doctoral | en_ZA |
| dc.format.extent | 523 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/123679 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Neglected diseases | en_ZA |
| dc.subject | UCTD | en_ZA |
| dc.subject | Decision support systems | en_ZA |
| dc.subject | Incentive (Psychology) | en_ZA |
| dc.subject | Pharmaceutical research | en_ZA |
| dc.subject | Human beings -- Diseases | en_ZA |
| dc.title | Selecting incentive interventions to encourage pharmaceutical research and development for neglected diseases: A decision-support framework | en_ZA |
| dc.type | Thesis | en_ZA |