OnCo
ideasIdea

Patent term extension scaled to proven survival gain

A drug that adds years of life would earn extra years of market protection; one that adds a few weeks would earn none. Extensions would be lost if the promised benefit is not confirmed.

Supplementary protection or regulatory exclusivity would be granted in proportion to demonstrated overall survival or cure-rate gain over the best prior standard in a randomised trial (for example one additional year of exclusivity per six months of median overall survival gain, capped at five years, with bonuses for curative-intent settings). Approvals on surrogate endpoints receive provisional extension that is confirmed or revoked when survival data mature. Regulators already collect the necessary data; the change is to the reward, not the evidence standard.

Hypothesis
Linking exclusivity to survival gain shifts industry portfolios: within a decade the share of pivotal trials with overall survival as a primary or co-primary endpoint rises substantially, and the average survival gain of approved drugs increases relative to the prior decade.
Rationale
Exclusivity is the main lever of pharmaceutical reward and is currently flat with respect to benefit; paediatric exclusivity extensions show that firms respond strongly to even six months of added protection. Value-based rewards are the explicit goal of ESMO-MCBS and ASCO value frameworks, which are advisory today.
What would test it
Use economic modelling with historical approvals to calibrate the schedule, then run a legislated pilot in one jurisdiction for new oncology approvals over five years, tracking endpoint choice and benefit magnitude of filings.
Maturity
speculative
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
6
Bottlenecks it attacks

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