1 Health inequalities: underlying factors and different ways of addressing them.
Regional Seminar for Certain African Countries on the ......3| Public health, innovation and...
Transcript of Regional Seminar for Certain African Countries on the ......3| Public health, innovation and...
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REPUBLIC OF SOUTH AFRICA
Regional Seminar for Certain African Countries
on the Implementation and Use of Several
Patent-Related Flexibilities
Durban, South AfricaJanuary 29 to 31, 2013
Topic 8: Compulsory Licenses
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Public health, innovation and intellectual property2 |
Enhancing Access to Medicines through
Licenses
Regional Seminar on Patent-Related Flexibilities
Dr. Peter Beyer
Enhancing Access to Medicines through
Licenses
Regional Seminar on Patent-Related Flexibilities
Dr. Peter Beyer
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Public health, innovation and intellectual property3 |
Some underlying health factsSome underlying health facts
� Between 20 % and 60 % of the health budget in LIC goes to
medicines expenditures
� In some countries, up to 80 to 90 % of medicines are purchased out-
of-pocket as opposed to being paid for by health insurance schemes
� In 2009, in 36 out of 89 countries for which data are available out-of-
pocket expenditures for health accounted for more than 50 per cent
of total health spending
� Average availability of selected generic medicines in LMICs:
– public sector less than 42 %
– private sector almost 72 %
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Public health, innovation and intellectual property4 |
What is a license?What is a license?
Contract between two parties = outcome of a
negotiation process
�Patent holder allows the contracting party to use the patent (to
exercise the patented invention)
�Against a payment of royalties or free-of-charge
�For a defined period of time
�Worldwide or in specific countries (defined territory)
�Subject to additional conditions
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Public health, innovation and intellectual property5 |
Recent compulsory licenses & government use
Country Medicine Indication Measure Period Royalties Remarks
India trastuzumab;
ixabelone;
dasatinib
Breast
cancer;
leukemia
CL 2013 To be
decided
Decision
pending
Ecuador abacavir/lam
ivudine
HIV/AIDS CL 2012 5% Local prod.
Indonesia Seven
products
HIV/AIDS;
hepatitis B
Gov use 2012 0.5% Local prod.
India sorafenib Cancer CL 2012 6% Local prod.
Ecuador ritonavir HIV/AIDS CL 2010 5% Import; local
prod.
Thailand erlotinib;
letrozole;
docetaxel;
clopidogrel;
Lopinavir/rito
navir
Cancer,
heart
disease
HIV/AIDS
Gov use 2006-2008 3-5% Import
Brazil efavirenz HIV/AIDS CL 2007 1.5% Import &
local prod.
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Public health, innovation and intellectual property6 |
Example: India/sorafenibExample: India/sorafenib
Anti-cancer medicine: sorafenib (Nexavar -
Bayer)
Compulsory license issued on request of local
generic company in 2012 for local production.
Reason: unaffordable price
•Generic price: USD 175/120 tablets
•Originator price: USD 5500/120 tablets
= 97% reduction
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Public health, innovation and intellectual property7 |
Example: Brazil/efavirenzExample: Brazil/efavirenz
HIV/AIDS treatment: efavirenz (Merck
Sharp&Dome)
Government issues a CL after protracted
negotiations with the patent owner.
Reason: high price
•Generic price: USD 0.43 per dose
•Originator price: USD 1.59 per dose
= 73% reduction
But it took two years to set up local production…
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Public health, innovation and intellectual property8 |
Example: South Africa/stavudineExample: South Africa/stavudine
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Public health, innovation and intellectual property9 |
Example: oseltamivir Example: oseltamivir
Problem:
– Threat of H5N1 (avian flu)
pandemic: patent holder
faced explosive demand
– Countries threaten to use
compulsory licenses
– Some countries later
discover that there is no
patent
– one compulsory license
issued, but finally not used
Solution:
– Patent holder issues a
worldwide call to apply for
sub-licenses
– Royalty-bearing licenses
granted to four generic
companies
– Limited to pandemic
preparedness (emergency
situation) allowing for
governmental stockpiling
Pandemic pressure leads to licenses:
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Public health, innovation and intellectual property10 |
Socially responsible licensingSocially responsible licensing
Objective:
� To ensure that licenses are negotiated in a way that
facilitates access to the licensed product in countries in
need of affordable prices/for patients
Adds a dimension of social responsibility to the economic
dimension of licensing without necessarily compromising
the business (in developed countries)
� When is a license socially responsible?
Objective:
� To ensure that licenses are negotiated in a way that
facilitates access to the licensed product in countries in
need of affordable prices/for patients
Adds a dimension of social responsibility to the economic
dimension of licensing without necessarily compromising
the business (in developed countries)
� When is a license socially responsible?
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Public health, innovation and intellectual property11 |
Voluntary licenses
Company Medicine Indication Geographic
al scope
Number of
Licensees
No of
countries
Remarks
BMS ATV
ddI; d4T
HIV/AIDS SSA, India 7
>3
48
50
immunity-
from-suit
Boehringer NVP/TPV HIV/AIDS All Africa,
LDC, LIC;
India
Several 75 immunity-
from-suit
agreements
Gilead /
MPP
TDF (FDC)
EVG/Quad
COBI
HIV/AIDS unlimited Country list 112
100
103
MSD
(Merck)
EFV
RAL
HIV/AIDS SA
SSA, LIC
6
2
1
60
EFV: No
patents in
SSA outside
SA
Roche SQV
oseltamivir
HIV/AIDS;
influenza
SSA; LDC
Africa;
China; India
13 65 oseltamivir
for pandemic
prepared.
Tibotec
(J&J)
DRV
ETR
RIL
HIV/AIDS SSA; LDC;
India
Country list
2
2
5
65
65
112
ViiV (GSK&
Pfizer)
AZT; 3TC;
ABC
HIV/AIDS SSA; LDC;
LIC
11 68
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Public health, innovation and intellectual property12 |
Initiated by UNITAID in 2010
with the objective to
� negotiate license agreements with companies regarding HIV/AIDS
products, with the aim of sub-licensing these products to generic
companies to increase access to treatment in low- and middle-
income countries.
� assemble the necessary intellectual property rights regarding key
HIV/AIDS products in order to develop new fixed-dose combination
products that unite different products in one pill or formulation
� develop missing paediatric formulations of existing treatments.
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Public health, innovation and intellectual property13 |
Medicines Patent PoolMedicines Patent Pool
Achievements
− Expansion of territory for licenses
− License to Gilead’s TDF (tenovofir) combination with other products.
− In collaboration with WIPO establishment of patent database for antiretrovirals
Criticism
− But still limited territory
excluding most middle-
income countries
− Relation between royalties
and actual patent coverage
− Transparency of the process
− Involvement of patient groups
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Public health, innovation and intellectual property14 |
Trends & Challenges: Compulsory licenseTrends & Challenges: Compulsory license
� established flexibility under TRIPS Agreement
� has been used by a number of countries to lower prices
and make medicines more affordable with a recent
increase in 2012
� initially focus on HIV/AIDS, now also medicines for non-
communicable diseases
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Public health, innovation and intellectual property15 |
Trends & Challenges: Voluntary licensesTrends & Challenges: Voluntary licenses
� Competition policy, Medicines Patent Pool and industry’s attention to
performance ratings on Access to Medicines Index led to expansion:
7 out of 8 originator ARV companies grant licenses
� More recent agreements cover new and pipeline products, but
limited to HIV/AIDS
� Average territory expanded from SSA, LDCs and LICs to up to 112
countries. (Upper)-middle-income countries still mostly excluded
� Trend towards lower royalties; except for agreements covering new
products and more extensive territory
� Agreements have to ensure robust competition and include tech
transfer where necessary
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Public health, innovation and intellectual property16 |
ContactContact
Dr Peter Beyer
Senior Advisor, WHO
P. Beyer. Developing socially responsible intellectual property
licensing policies – voluntary licensing initiatives in the
pharmaceutical sector. Research Handbook on Intellectual
Property Licensing. Edward Elgar, 2012 (forthcoming).