The COVID-19 innovation system

The coronavirus disease 2019 (COVID-19) pandemic response brought forth major changes in innovation policy. This article takes stock of the key features of the COVID-19 innovation system-the network of public and private actors influencing the development and diffusion of technologies to combat the pandemic. Before the pandemic, biomedical research and development policy consisted largely of "push" funding from the public sector in support of basic research and "pull" incentives from patents to motivate private companies to invest in clinical trials and develop drugs and vaccines. In contrast, during the pandemic, public funding shifted its focus to late-stage product development and manufacturing. Procurement agreements with governments replaced traditional pull incentives from patents for the major private companies. Nonpatent barriers to competition may also have incentivized innovation. The challenges to ensuring diffusion have gained in prominence during the pandemic, though it is unclear what role patents will play in pricing and access. Some aspects of this approach to biomedical innovation may be unique to crises, but others could provide lessons for policy beyond the pandemic.