Entries by Robert Weissman

On October 26, 2009 Ecuador’s President Rafael Correa declared access to priority medicines affecting the health of the Ecuadorean population to be a matter of public interest. Under Andean Community law, the declaration opens the door to competition of generic medicines with patented brand-name drugs, through use of an internationally recognized legal mechanism called compulsory licensing. The declaration could lead to government policies that expand access to medicines.

You can download a .doc version of an unofficial English translation of the declaration here: Decree_CorreaEnglishunofficialtranslation.doc

Dear Colleagues,

On Monday October 5 I wrote you about Ecuador's plans to expand access to medicines by issuing compulsory licenses, and about President Correa's vision for intellectual property "as a mechanism for development for the people" (see my post at the bottom of this email for a reminder and an excerpt of President Correa's comments). Compulsory licenses authorize generic competition with patented medicines, reducing costs and enabling more people to access treatment. Discussions on a compulsory licensing administrative framework are advancing in Quito. This is a critical moment in the discussion, and we would like to show President Correa he has the support of the access to medicines movement.

Essential Action is collecting signatures in support of President Correa's vision, and reiterating the benefits of TRIPS-compliant compulsory licenses. See our letter below. If you would like to sign on, please send your organization's name (or your name and organizational affiliation, if any, if you would like to sign on as an individual), your mailing address and email address to . For organizations and individuals able to arrive at a decision quickly, we would appreciate your signature right away – by this Sunday October 11th if possible. The outside deadline for sign-ons is Wednesday, October 21. Please feel free to send me any questions you may have.

Thank you,
Peter Maybarduk
Essential Action

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In July of this year, Ecuador’s President Rafael Correa articulated a vision of intellectual property as “a mechanism for development for the people.” His speech before a live audience on the nationally televised program "Enlace Ciudadano" ("Citizen Connection") announced a new state policy of using compulsory licenses to improve access to medicines.

I’ve translated an excerpt below. The clip is available (in Spanish and sign language) on YouTube here, as well as the homepage of the Ecuadorean Intellectual Property Institute (IEPI, Ecuador’s patent office), here.

Last week, President Correa announced plans to use compulsory licenses to facilitate the domestic production of medicines. Here is the story in El Universo, courtesy of Judit Rius Sanjuan.

Correa, an economist recently elected to a second term (with a simple majority and a twenty-three point lead over his closest competitor), has charged high-ranking officials in his administration to implement the policy.

Nevertheless, we have heard reports of multinational pharmaceutical companies organizing behind the scenes to disrupt the licensing policy before it can take effect. To realize President Correa’s vision, Ecuador needs the support of the global access to medicines movement.

To show your support and find out how you can help, write:

Essential Action, peter.maybarduk@essentialinformation.org and

Health Action International Ecuador, teranj_aisec@cablemodem.com.ec

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San Mateo County Times/ Bay Area News Group
The Insider

Consumer groups are still hoping to persuade Congress during this month's health care reform negotiations to make it easier to create generic versions of drugs known as biologics.

Biologic drugs are created through biological, as opposed to chemical, processes — researchers use plant and animal cells to grow new molecules. They are far more complex than most chemically produced drugs and much harder to duplicate. The top-selling biologics include cancer drugs such as Avastin and several drugs used to treat rheumatoid arthritis and anemia.

Rep. Anna Eshoo, D-Palo Alto, authored an amendment, which was added to the House version of the health care reform bill in July, that would grant biotech firms a 12-year period of market exclusivity on biologics, more than twice the 5-year period that other drugs receive. A similar measure is in the works in the Senate.

Critics charge Eshoo with selling out the public on behalf of the biotech industry, a powerful special interest on the Peninsula and a major contributor to Eshoo's campaigns. Eshoo claims she's trying to balance the interests of consumers and biotech companies, which spend billions developing these drugs.

Sarah Rimmington, an attorney for consumer group Essential Action, called Eshoo's amendment an "unjustified price gouge of the American public." She said 12 years of market exclusivity is far too long and called into question the pharmaceutical industry's claim that biologics are far more expensive to produce than other kinds of drugs.

Rimmington also blasted a clause in the amendment that critics claim would allow biotech companies to restart their 12-year window every time they make minor adjustments to their drugs — combining two types of drugs, for instance, or providing them in different doses — a process known as "evergreening."

Consumer groups were recently joined in the biologics fight by student groups, including the American Medical Student Association and Universities Allied for Essential Medicines. In a statement issued by the student groups on Monday, Yale University medical student Sara Crager said that, as a future biomedical researcher, "I want the fruits of my research to be available as widely as possible as soon as possible."

Eshoo's office disputes the notion that biologics are no more expensive to produce than other drugs. The 12-year window is based on the average amount of time a biologic stays on the market before its patent expires, staffers say.

If biotech companies sink billions into biologics research, only to see generic versions, or biosimilars, appear on the market too quickly, they will lose their incentive to do that research, slowing down the development of potentially lifesaving drugs, proponents of the amendment argue.

Pharma Times
By Lynne Taylor

US campaigners yesterday urged Congress to create a “real” regulatory pathway for generic versions of biologic drugs, but researchers warn that it may take until 2011 to implement any such policies.

Current proposals for a regulatory pathway for generic biologics - also known as biosimilars, biogenerics or follow-on biologics - in Senate and House healthcare reform bills will actually block production of most generic biologics, but if these are improved in critical ways they could save $71 billion or more in the first decade alone, say the consumer and medical student groups which are leading the campaign.

The proposals, originating from Representative Anna Eshoo House bill HS 1548 and past bills in the Senate, would provide 12 years’ market exclusivity for biosimilars compared to five years for other drugs. However, the campaigners point out, the Pharmaceutical Research and Manufacturers of America (PhRMA) puts development costs for biologics at $1.2 billion, close to that for conventional drugs at $1.318 billion, and that the Federal Trade Commission (FTC) recommends zero years market or data exclusivity for biologics, given that biosimilars will cost more to bring to market for generic manufacturers than conventional generics, leaving originator companies with 70%-90% of the market.

These proposals will also allow “evergreening,” whereby pharmaceutical companies will be allowed additional 12-year periods of exclusivity for “relatively inexpensive minor tweaks” which, they say, could block price-lowering generic competition indefinitely.

The language in these bills creates biologic drug monopolies, which discourage innovation and raise costs for the US health system, say the campaigners. However, they add that these problems can be addressed by adopted the relevant sections of bills introduced by Representative Henry Waxman (HR 1427) and Senator Charles Schumer (S 726), which would allow five years’ exclusivity and block evergreening.

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Healthcare Reform Offers Only the Illusion of Generic Competition for Biotech Drugs: Patient Access To Expensive New Medicines at Stake

U.S. Congress is considering proposals to establish a process for regulatory approval of generic versions of biotech drugs ("biologics"). The Food and Drug Administration (FDA) approval process available for conventional pharmaceuticals does not apply to biologics, which are drugs engineered from human or animal cells using biotechnology. New and different procedures are required to demonstrate the safety and efficacy of comparable and interchangeable biologic pharmaceuticals (called “biosimilars” or “biogenerics”).

Proposals passed by the Senate and House health committees as part of healthcare reform in July 2009, however, will establish prolonged delays before permitting price-lowering generic competition. Even worse, they will facilitate brand-name companies’ ability to renew their monopolies, potentially keeping generic firms out of the market for biologics altogether and creating only the illusion of generic competition. Either result will torpedo the objective of healthcare cost containment so crucial to current reform efforts, and severely limit patient access to these important and exceptionally high-priced medicines for conditions like cancer, arthritis and diabetes.

The bottom line is this: Under these proposals, Medicare and other federal programs will find their budgets increasingly strained by growing biologic drug costs. Employers will continue to struggle to provide affordable health insurance to their employees. Americans with insurance will find it even more difficult to pay for their already sky-high prescription drug co-payments. And the uninsured may have to go without crucial lifesaving biologics.

For more information, download the .pdf version of the briefing note here: BiologicsBriefingNote28_Sept_09.pdf

Download a .rtf version of the briefing note here: BiologicsBriefingNote28_Sept_09.rtf

For more details about one of the most pressing issues in these proposals, the creation of almost indefinite monopolies through the evergreening of the data exclusivity monopoly, please see the fact sheet available here.

FOR IMMEDIATE RELEASE
September 28, 2009

Contact: Sara Crager, MD PhD, Yale University, and member, Universities Allied for Essential Medicines (UAEM)
Phone: (203) 444-4805 Email: sara.crager@yale.edu

Contact: Ethan Guillen, Director, Universities Allied for Essential Medicines (UAEM)
Phone: (775) 287-2553 Email: ethan.guillen@essentialmedicine.org**


CURRENT PROPOSALS IN HEALTHCARE REFORM BILLS WILL BLOCK MOST GENERIC BIOLOGICS

Student and consumer groups, Universities Allied for Essential Medicines (UAEM) and the American Medical Student Association (AMSA), supported by consumer groups Essential Action and Knowledge Ecology International, are today calling on Congress to create a real pathway for the production of generic biologics. Current proposals for generic biologics or “follow-on biologics” in Senate and House versions of healthcare reform legislation that purport to create such a pathway will actually block production of most generic biologics, which -- if the current proposals are improved in critical ways -- could save $71 billion or more in the first decade alone.

The organizations involved support healthcare reform now, but urge Congress to fix this serious challenge to future affordable access, both here and abroad, which could also create tremendous savings for the healthcare system.

To engage and educate consumers and patients from across the United States
in the fight for affordable medicines, UAEM and AMSA have launched a website, http://www.AffordableMedsNOW.org

Comunicación Positiva, a Colombian NGO that develops communication strategies for civic engagement and human rights, has produced a series of documentary audio programs and a video short covering the evolution of the HIV/AIDS compulsory license & access to medicines campaign in Colombia, 2008-2009. The Spanish-language series is entitled "For the right to health – no to patents!" ("Por el derecho a la salud – no a las patentes!"), and features interviews with about thirty activists, analysts and people living with HIV/AIDS.

Check out the video introduction (in spanish) on Youtube here.

To download a zip file (higher-resolution version also in spanish), click here.

To listen to the audio series (in spanish), visit this site.

The audio series (in spanish) is also available on CD from Comunicación Positiva. Contact: David Morales; david.morales.alba@gmail.com

Bogotá, Colombia – Wednesday, September 16, 2009 –

Today, NGOs, attorneys and activists filed suit in Colombian court to compel the government to authorize price-lowering generic competition with Abbott Laboratories' costly HIV/AIDS treatment Kaletra (lopinavir+ritonavir, LPV/r).

The "acción popular" demands an open compulsory license allowing any producer that can demonstrate drug safety and efficacy and good manufacturing practices to use patented technology to bring generic LPV/r to market.

Chicago-based Abbott enjoys a LPV/r monopoly in Colombia, where Kaletra, a key second-line HIV/AIDS medicine, ranks consistently among the health system's most expensive annual medicine purchases and routinely sells for well over $3,000 per person per year. Global competitive prices have dropped under $500. Earlier this year, in response to Colombian NGOS administrative request for a compulsory license, the Colombian government imposed price ceilings on the drug – approximately $1,000 for public sector sales and $1,600 for the private sector. But recent reports suggest Abbott has violated the price order in its transactions with at least some purchasers. The National Commission on Medicine Prices is investigating.

The eighty-page acción popular cites state failures to provide for Constitutional and collective rights to health. It names the health ministry, patent office, drug regulatory authority and Abbott Laboratories as defendants. Plaintiffs include Fundación IFARMA, Fundación Misión Salud, RECOLVIH (Colombian network of people living with HIV/AIDS), and attorneys Luz Marina Umbasía (in her personal capacity), Giomar Angélica Aguilar and Germán Rincón Perfetti.

We will occasionaly issue updates on the suit's progress and also hope provide more information soon. With questions, English speakers can contact Peter Maybarduk at Essential Action (peter.maybarduk@essentialinformation.org) or Francisco Rossi of the Colombian Foundation IFARMA, a plaintiff in the suit (francisco_rossi@hotmail.com).

Earlier this year, Colombian HIV/AIDS groups won major price reductions for the antiretroviral drug lopinavir + ritonavir (Abbott Laboratories' Kaletra) through a compulsory license campaign. While the Colombian health ministry eventually turned down the license request "for now", the campaign moved the government to fix a price ceiling for Kaletra, some 54-68% lower than Abbott's previous prices. The price ceiling should reduce the average annual treatment cost per person by about $2,000 per year.

Nevertheless, reports are surfacing that Chicago-based Abbott may be defying the price order in its sales to some buyers. The National Medicines Pricing Commission (Cnpm), which imposed the ceiling, is investigating. An article this week in El Tiempo , Colombia's largest newspaper, quoted an anonymous knowledgeable source in Colombia's largest healthcare providers association, saying Abbott's prices have not changed. (Officially, the association reported it could not disclose the prices it pays Abbott, due to a confidentiality agreement.) And receipts from a separate source show at least one consumer recently paid prices considerably higher than the ceiling.

Although Abbott has not commented on the reports, it has petitioned the government to revoke the price order.

Health Minister Diego Palacio sent healthcare providers a letter last week concerning lopinavir+ritonavir's new price, saying the state "will prevent any person or company from abusing their dominant position in the market." If the Pricing Commission's investigation reveals Abbott has failed to comply with the price order, it will refer the case to the Agency for Industry and Competition (SIC) to levy sanctions.

Notably, Abbott's refusal to comply with the price order would provide Colombia new and persuasive legal grounds to issue a compulsory license: precisely the anti-competitive conduct cited by Minister Palacio in his letter. In order to maintain credibility and preserve its authority, the Colombian government needs to take swift and stern action. Colombian HIV/AIDS groups will make the case.

The El Tiempo article is available in Spanish in the continuation of this post.
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