Wednesday, May 9, 2018

5 unintended consequences of addressing the opioid crisis




It’s not unusual for U.S. presidents from either political party to advocate for strong intellectual property protections for drug companies overseas. The Obama administration, for example, pushed for 12 years of biologic medicines exclusivity in the Trans-Pacific Partnership trade agreement. Obama officials also went to bat for the drug industry when low-income countries tried to issue compulsory licenses to break patents and make cheaper medicines for diseases like cancer. But advocates say Trump’s backing of this status quo is notable, given his strident populist drug-bashing.

“We were sort of back in the ‘90s with the intellectual property maximalist agenda,” ‘t Hoen said.

Trump has also brought the global pharmaceutical debate into the domestic dialogue. He’s gone to the American people and blamed other countries for high prices in a way that past presidents did not.

“The Trump administration has been consistent and explicit about its stance that the lower prices that some countries manage to pay are a problem to be fixed rather than a practice to be studied for possible benefits at home,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines Program.

Others say that Trump has gone further than past presidents by shepherding drug industry interests abroad in areas besides trade. At a WHO meeting in January, the administration fought ideas like greater transparency about R&D spending — an idea that has gotten some bipartisan support in Congress. They portrayed it as “some big attack on the pharmaceutical industry,” said Jamie Love, director of Knowledge Ecology International, a nonprofit that pushes for broader access to medical technology.

Garrett Grigsby, director of HHS’ Office of Global Affairs, told a meeting of the WHO executive board that “requiring companies to attempt to calculate and then disclose research and development costs are impractical and unlikely to be effective.” He added that it could even prompt drug companies to abandon risky research that could benefit "the vulnerable communities we are meant to serve and humanity as a whole."

Defenders of the Trump agenda argue that strong intellectual property laws and reimbursement for medicines overseas are critical for the new drug pipeline, which requires millions, even billions of dollars.

“Innovators and creators need to be fairly compensated for their work,” said Brian Pomper, executive director of ACTION for Trade, which includes business groups and the two major U.S. drug lobbies, PhRMA and BIO. “It’s a natural human instinct to want to get stuff for free,” but if goods are free, he argued, no one will create or disseminate them.

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