[Ip-health] Denver Post: Rationing life-saving medicines in Thailand

[Sarah Rimmington]

http://www.denverpost.com/search/ci_8785780
Guest commentary
Rationing life-saving medicines in Thailand
By Robert Weissman
Article Last Updated: 04/02/2008 05:16:55 PM MDT

Denver Post readers might reasonably have been confused by Professor
Kristina Lybecker's astounding claims in a March 18 online guest
commentary ("Compulsory drug licensing disastrous"). Professor Lybecker
alleged that Thailand's efforts to lower the price of life-saving
medications and make them available to poor people would have a
"disastrous effect on public health worldwide."

Readers might have been able to put this remarkable and misguided
argument in context if Professor Lybecker had revealed her extensive
financial entanglements with Big Pharma.

Professor Lybecker takes issue with Thailand's decision to issue
"compulsory licenses" on several AIDS, heart disease and cancer drugs.

A compulsory license is a lawful government authorization of generic
competition for products while they remain on patent.

The Thai compulsory licenses have lowered the price of an important
HIV/AIDS drug (brand name: Kaletra) by about three quarters, enabling
the government to triple the number of people receiving this life-saving
treatment. The generic version of a heart-disease drug (brand-name:
Plavix) is 1/70th the cost of the brand-name product, enabling the
government to offer the drug in the public health system.

Previously, it was unavailable.

The price reductions obtained by Thailand have benefited the rest of the
world. After Thailand issued its compulsory license on Kaletra, for
example, the maker of the brand-name version, Abbott, lowered its
middle-income-country price from $2,200 a year per person to $1,000.

Professor Lybecker contends that poverty is "actually responsible" for
people in developing countries not being able to obtain medicines (a
problem not limited to poor countries). Of course poverty affects
people's ability to access medicines.

But price matters, too. Consider the case of first-line HIV/AIDS drugs.
Less than a decade ago, they cost as much in developing countries as in
rich nations -- more than $10,000 a year per person, an amount that
meant an HIV diagnosis almost everywhere in the developing world was a
death sentence. Now, thanks to generic competition, including due to
actual and threatened compulsory licenses, the same drugs are available
for as little as $100 a year.

As a result, roughly 3 million people in developing countries are
receiving life-saving treatment.

Professor Lybecker also writes that compulsory licensing and efforts to
introduce generic competition will undermine incentives for brand-name
drug companies to invest in treatments and cures for diseases unique to
developing countries. But as even Big Pharma acknowledges, the companies
have no such incentive now -- there is too little buying power in
developing countries to justify investments for diseases unique to
poorer countries.

Professor Lybecker's misleading and deceptive commentary closely
reflects the interests of Big Pharma, not public health. Perhaps this
coincidence is related to her past and current relationships with Big
Pharma, associations not revealed in her commentary or accompanying bio.
According to her c.v., Professor Lybecker is presently a consultant for
the brand-name pharmaceutical industry trade association, PhRMA -- the
Pharmaceutical Research and Manufacturers of America, and a consultant
to a communications firm that works for the industry. She has held
several other consultancies for brand-name pharmaceutical companies, and
received research grants from Big Pharma.

The world desperately does need more medical inovation, inncluding but
not only for diseases endemic to developing countries. The current
system is doing poorly on this score. There are too few resources
devoted to priority health R&D needs, from new antibiotics to new
tuberculosis drugs.

But we can and must find ways to support R&D that do not result in the
rationing of life-saving medicines in developing countries, and denial
of life-saving treatment to people simply because they are poor. One
promising idea is prize funds, which would offer rich rewards for those
who make important medical discoveries, but not require patients to pay
high prices.

There is growing interest in the U.S. Congress in searching for such
win-win arrangements. Senate Resolution 241/House Resolution 525, for
example, proposes a U.S. trade policy aiming to promote pharmaceutical
innovation and access alike.

Robert Weissman is director of Essential Action, a public health
advocacy and corporate accountability group based in Washington, D.C.
Funding for Essential Action's Access to Medicines campaign comes from
the Ford Foundation and the Open Society Institute.

--
Sarah Rimmington
Attorney
Essential Action, Access to Medicines Project
Washington, DC
Tel: (202) 387-8030
Cell: (202) 422-2687
www.essentialaction.org/access/