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Open Access Research

Does market exclusivity hinder the development of Follow-on Orphan Medicinal Products in Europe?

Anne EM Brabers1*, Ellen HM Moors2, Sonja van Weely3 and Remco LA de Vrueh3

Author Affiliations

1 NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands

2 Innovation Studies, Copernicus Institute, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, the Netherlands

3 Dutch Steering Committee on Orphan Drugs, Laan van Nieuw Oost Indië 334, 2593 CE Den Haag, the Netherlands

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Orphanet Journal of Rare Diseases 2011, 6:59  doi:10.1186/1750-1172-6-59

Published: 5 September 2011

Abstract

Background

We determined whether the market exclusivity incentive of the European Orphan Drug Regulation results in a market monopoly or that absence of another Orphan Medicinal Product (OMP) for the same rare disorder, a so-called follow-on OMP, is a matter of time or market size. In the interest of rare disorder patients better understanding of the effect of the market exclusivity incentive on follow-on OMP development is warranted.

Methods

First, the impact of various market-, product- and disease-related characteristics on follow-on OMP development in the EU was determined by comparing rare disorders with an approved OMP and at least one follow-on OMP (N = 26), with rare disorders with an approved OMP and no follow-on OMP (N = 18). Next, we determined whether manufacturers continued development of a follow-on OMP upon approval of the first OMP for the intended rare disorder. Since in the EU significant benefit of an OMP has to be established, we determined for each follow-on OMP for which development was continued on what grounds significant benefit was assumed by the sponsor. Data were collected from the public domain only.

Results

The likelihood of a rare disorder with an approved OMP to obtain at least one follow-on OMP development was strongly associated with disease prevalence, turnover of the first OMP, disease class, disease-specific scientific output and age of onset. Out of a total of 120 follow-on OMPs only one follow-on OMP could be identified for which development was discontinued upon approval of the first OMP for the same rare disorder. Only a substantial level of discontinuation of follow-on OMP development would have indicated the existence of a market monopoly. Moreover, sponsors that continued development of a follow-on OMP predominantly assumed that their product had an improved efficacy compared to the first approved OMP.

Conclusions

This study provides evidence that absence of follow-on OMP development is a matter of time or market size, rather than that the market exclusivity incentive of the European Orphan Drug Regulation creates a market monopoly.