Bridges vol.11 no.1.pmd

Thailand Continues the Battle for Cheaper Drugs
The Thai government may allow generic production of more than a dozen patented medicines unless companies substantially lower the price of their brandname products. Three compulsory licenses for domestic production and import have already been issued.
Thailand’s Ministry of Public Health has set up a panel to review whether compulsory licenses ciation’s president Teera Chakajnarodon told should be granted for at least ten patented drugs in addition to the three issued in November Reuters that the government’s action was 2006 and January 2007 (see below). According to reports in Thai press, these could include medicines to treat diabetes, cancer, cholesterol-related diseases and possibly some antibiotics, world” and could result in companies de- but health officials have not confirmed the exact number or the names of the drugs under ciding against marketing their latest drugs consideration. Public Health Minister Mongkol na Songla told the Thai News Agency on 13 February that no compulsory licenses would be issued in the near future, and that the minis- try hoped that brandname pharmaceutical manufacturers would engage in a dialogue with about the legality of licenses granted with- the government over a long-term strategy for public access to quality medical treatment. If out prior consultation, none have alleged a companies brought prices down, Thailand would not “have to enforce compulsory licensing violation of the WTO’s TRIPS Agreement.
because we honestly don’t want to,” he said.
Kaletra, Plavix Targeted
Public Health explicitly confirms that gov- On 29 January, the Thai government granted compulsory licenses for the AIDS drug Kaletra ernments have the “right to grant compul- (lopinvir/ritonavir) manufactured by Abbot Laboratories and Plavix (clopidogrel bisulfate), a sory licenses and the freedom to determine blood thinner used to treat heart disease, jointly marketed by the US-based Bristol Myers Squibb and France’s Sanofi-Aventis. Generic copies of these would at least initially be im- granted.” According to Professor Frederick Abbott of Florida State University, thenotion that there is a ‘scope of diseases’ limi- The decision to produce generic Plavix without the rightholder’s consent was somewhat tation on the medicines for which compul- unusual as most compulsory licenses are granted for medicines that treat epidemics rather than sory licenses could be issued is spurious.
non-communicable diseases. Thai health officials say that only 20 percent of the 200,000 “The idea that compulsory licensing of pat- patients that need Plavix – the world’s second best-selling drug in 2005 – currently receive it.
ents is limited to treatments for HIV/AIDS Generic production would cut the price per tablet more than ten-fold from about US$2.06 or ebola, as opposed to treatments for coro- to 18 cents. Bristol Myers Squibb has not publicly commented on the case.
nary disease and diabetes, is flat wrong,” hesaid.
Abbott, however, said in a statement that it did not view the decision to issue a compulsorylicense for Kaletra ‘as legal or in the best interest of patients’. Nevertheless, the company swiftly entered into negotiations with the Thai Ministry of Public Health and was reported by Thai was seriously criticised for suggesting on 1 press to have offered on 8 February to lower the price of Kaletra from US$347 a month per patient to US$167. This is still considerably higher than the US$120 Indian generic manu- negotiate with drug companies before tak- facturers charge for a month’s lopinavir/ritonavir treatment, and discussions reportedly con- ing action. A week later, she wrote to Min- tinue between Abbott and Thai authorities on a further price reduction. In 2005, Abbott agreed to cut its Kaletra price for Brazil rather than face a compulsory licence.
embarrassment her remarks might havecaused and confirmed that Thailand’s deci- Merck to Lower Price
sion to issue compulsory licenses was “en- In November 2006, Thailand issued a compulsory license for the AIDS drug efavirenz, under tirely the prerogative of the government, which it intends to first import a generic version of the medicine from India and later manu- facture it locally (Bridges Year 10 No.8 page 16). Patented efavirenz is marketed by Merck & ment.” She also said that there was “no re- Co as Stocrin, and a month’s treatment cost around US$40 when the Thai compulsory license quirement for countries to negotiate with was issued. A one-month course of the Indian-made generic was about half the price. On 14 patent holders before issuing a compulsory February, however, Merck announced that it was making Stocrin available at US$0.65 per licence” and that the WHO unequivocally day for the poorest countries and middle-income countries with an adult HIV prevalence of supported developing countries’ use of the one percent or more. As a result, the cost of a monthly course of Stocrin treatment would drop flexibilities within the TRIPS Agreement, to US$19.6 in Thailand. Merck cited ‘efficiencies resulting from improved manufacturing including compulsory licensing. In related processes’ as the reason for the new offer and did not mention Thailand in its press release.
news, the UNAIDS Executive Director Pe-ter Piot on 8 February wrote to the Thai No TRIPS Violations Alleged
While health activists have applauded the efforts to widen access to affordable medicines, the government for taking steps to ensure uni- government’s compulsory licensing strategy has raised an uproar from original drug produc- versal access to affordable HIV/AIDS treat- ers, including Thailand’s Pharmaceutical Research and Manufacturers’ Association. The asso- No. 1 | February - March 2007 | |


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