Alternative Pharmaceutical Innovation Models in Competitive Markets: A Collaborative Approach to Develop a Novel Drug for Hepatitis C.

Alternative innovation models have emerged to address failures of the traditional pharmaceutical system, particularly for diseases where market incentives do not attract sufficient research and development efforts. However, the feasibility of such models for diseases with significant markets is not well-established. This article analyses the development of a novel drug (ravidasvir) for the treatment of hepatitis C, a highly profitable market. Data from qualitative research methods, including literature reviews and semi-structured interviews, was analyzed using a novel conceptual framework focusing on actors, resources, organizational practices, and outcomes. Dissimilar to other projects, ravidasvir did not involve any major pharmaceutical companies. Rather, it leveraged the capacities of actors less traditionally involved in the development of novel medicines by constructing a collaborative network of private and public partners from low- and middle-income countries with a shared goal. The collaboration was successful in developing a highly effective, easy-to-use, and affordable medicine and contributed significantly to capacity-strengthening. However, the case also highlighted that strategic behavior by competing for-profit firms could pose significant challenges and that changing external conditions reduced the potential public health impact of the drug. Lessons from ravidasvir can inform future efforts to develop alternative innovation models for therapeutic areas with significant commercial interest.