Asset, Patent, Lifesaver: The Multiple Ontologies of an Essential Drug

• In Event: Organizing Technoscientific Capitalism: Epistemic Values, Practices & Assets - II

Abstract

The growing literature on ‘biofinance’ (Glabau, Fiereck and Sherman 2017) or the ‘bio-economy’ (Birch 2017) has highlighted some of the controversies arising from the coupling of moral, social, political and economic values in a single object such as a medical device (Glabau 2017; Geiger and Gross, 2019). With this paper we take a different tack by interrogating the biomedical object as ontologically multiple (Mol, 2002): as a patent, as an asset, and as a lifesaver. The object in question is the Hepatitis C medication sofosbuvir, a drug able to effectively treat Hepatitis C and subsequently reduce the long-term consequences of the illness. Its parent company Gilead’s pricing strategy - $1,000 per pill or a total of $84,000 per course of treatment – has been at the centre of a global debate over predatory pricing practices in the pharmaceutical industry (Quet, 2017). It has also led to a more fundamental questioning of the patent system that enables monopoly price setting practices in the first place, as illustrated for instance through the 2018 patent challenge by 17 activist organisations against Gilead’s sofosbuvir patent in the European Patient Office (EPO). We argue that controversies over biomedical pricing can be better explained if we understand the drug as “the enactment of different objects in the different sets of relations and contexts of practice” (Law and Singleton, 2005, 342) rather than focussing on the multiple values present in one object. By focussing on the 2018 EPO challenge, we interrogate what happens when these multiple ontologies of an object are fundamentally incompatible, yet courts are asked to adjudicate between them. [references available upon request]

Authors

• Stephen Nicola, University College Dublin

• Susi Geiger, University College Dublin