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IPR &
       Access to Medicines in Thailand


                                                     




                      Dr. Jiraporn Limpananont
    Foundation For Consumers (FFC)
  
   Drug Study Group (DSG)
   FTA Watch
   Social Pharmacy Research Unit, Faculty of

        Pharmaceutical Sciences, Chulalongkorn University.

                                                                                         1
Dr. Jiraporn Limpananont, Faculty of Pharmaceutical Sciences, Chulalongkorn University
Scope: IPR & Access to Medicines
    IPR Protection: Patent Act


     Raise up the innovation?
     High price, un-affordable
     Impact on the Generic Drug Manufacturing: destroy the
      local generic drug manufacturer
     FTA and Trade Pressure: TRIPs Plus on IPR for drugs
    3 Cases of consumers’ movement for Access to


    Drugs”
     Revocation: ddI case
     Pre-grant opposition: combid case
     CL implementation

                                                                            2
      Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Impact on Generics Industry

 R&D on NEW DRUGS
                        R&D on RAW MATERIALS
                                                           R&D on DRUG FORMULATION


            A+B
            X+Y
                                                                                  FINISHED
                                              ACTIVE
                                                                                 PRODUCTS
                                           INGREDIENTS
Other materials
                                                                           PROCESS PATENT
                                                                           PRODUCT PATENT

                                                                                             3
     Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
IPR PROTECTION IN THAILAND
            Time Line
                         •Drug Process Patent
 2522(1979)
                         •15 years patent life
 Patent Act:
                         •Drug Product Patent
 2528(1985)
                         •20 years patent life
     USTR:
                                                                       •Group of pharmacists
                         •Drug Product Patent
 2535(1992)                                                            and friends
                         •20 years patent life
 Patent Act:                                                           •Cary on research
                         •Drug Patent Committee
                                                                       •Advocacy
 2538(1995) •TRIPs                                                     •People Mobilization
      WTO:
 2542(1999) •Abolish Drug Patent Committee
  Patent Act:
FTA Coming •DATA EXCLUSIVITY
      soon?: •Limit CL implementation
              •Extension of Exclusity Period

                                                                                               4
 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Event on the 6th
                                                                          round of Thai-US
                                                                          FTA negotiation




Chiamgmai, Thailand

Jan. 2005
                                                                                             5
    Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Case 1: Revocation of ddI patent
  ddI was invented by US NIH, licensed to BMS, and


  not allowed to be patented in developing countries,
 BMS did not patent ddI in Thailand but patented

  ddI formulation
 ddI formulation is not new, no inventive step, but it

  was patented
 The price is very high




                                                                          6
    Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Two ways of solving this problem
    Issue the CL since 2000


     Result: no CL was issued
    Revoke the Patent


     Result: BMS negotiated to end the case in the court by
      voluntary withdrew this patent




                                                                            7
      Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
TPN+ Camp asking for CL on ddI patent




                                                                       8
 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Case 2: Pre-grant opposition of combid
    Case:

     GSK filed for the formulation of AZT 300 mg + 3TC 150 mg
     AZT and 3TC were not patented in Thailand
     They were already used, not new and no inventive step
     The cheap generic version was sold
     If it was patented then GSK can monopolize the market, the price
        will be very high
    Civil Society Movement to


         Make opposition to this application
    
    Result:

     The process took more than 5 years
     Finally GSK withdrew this patent application
    Strategies:

     Put pressure on the unethical practice of GSK
     Mass media campaign and demonstration

                                                                              9
        Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
10
Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Case 3: CL of Government Use
    2 ARVs:


     Efavirenz commercially known as Stocrin, of MSD (on 29
      November 2006)
     Lopinavir/Ritonavir commercially known as Kaletra,
      made by Abbott (on 24 January 2007)
    1 Heart disease drug


     Clopidogrel commercially known as Plavix, made by
      Sanofi-Aventis (on 25 January 2007)




                                                                            11
      Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Diagram to demonstrate that the Government Use of patent does not
affect much on the existing market size of patented products

      % of population at each income level
                                          62 million Thais

                                  Social Welfare = 48.5 million




                                 Social Security = 8.5 mil.
                                 Civil Servant Medical
                                 Benefit Scheme = 5 mil.                                        Income
                                 Low                                                        High
                                                                              Out of
                                  People paid by public budget with no or
                                                                              pocket
                                    limited access to patented drugs –      payment –
                                        “New market for drugs from           “Existing
                                                                          market for high
                                             Government Use”              price patented
                                       “Public non-commercial use”            drugs”
                                                                            “Commercial
                                                                               use”

                                                                                                         12
     Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
TRIPS flexibilities
                                                                            Permission
    Non Public use: Prior negotiation                                       Royalty

                                                                            Terms of use
    Voluntary licensing
    Compulsory licensing
    Public Use: No need for prior negotiation

                                                                            Royalty
    National emergency
                                                                            Terms of use
    Extreme urgency
    Public non-commercial                                   use
(TRIPS 31(b): DOHA; Thai patent act section
  46-52)


                                                                                       13
      Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
After negotiation for 1.5 Yr                                     After CL Announcement
MSD
                                                            MSD
- Efavirenz – 1723 to 1401 Baht
                                                            - Efavirenz – Now is 770 Baht/Bottle
(~18.7% reduction in Baht
                                                            (~ 45% price reduction)
because of the Baht appreciation:
no reduction in terms of USD)
                                                       Abbott
Abbott                                                    - Strong reaction - 9 Dossier withdrew
- Kaletra – 17548 to 6000 Baht                         (including Kaletra film-coated tab)
(~66% reduction in Baht or                                - Kaletra – no WHO pre-qualified pdts
~57% reduction in USD)                                 available (expected to be available in film-
                                                       coated tab form in the next few months)

                                                        Roche
Roche                                                     - Saquinavir has no patent in Thailand,
- Saquinavir – 4852.66 to 4601                          but GPO is in the process of production
Baht (~5% reduction in Baht or                          development.
~15% increase in USD)                                     - Less used in National Health Program

                                                       BMS
BMS                                                      - Atazanavir (2nd line that can replace
- Atazanavir – No price reduction                      Lopinavir) – will be negotiated for price
                                                       reduction and/or CL

                                                                                                      14
    Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Reaction from USTR and Abbott
  Under Section 301, USTR put Thailand on the PWL


 Abbott withdrew all applications to register its new

  drugs in Thailand




                                                                          15
    Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Reaction from Civil Society: boycott Abbott




                                                                       16
 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Demonstration




                                                                      17
Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Worldwide Boycott Abbott’s Products




                                                                          18
    Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
Conclusion
    Patent in the field of pharmaceuticals:


     Market driven R&D not Public Health Need driven R&D
     No drugs for the treatment of the Poor's diseases
     Patented drugs are un-affordable for the Poors
    What should we do for access to medicines ?





                                                                            19
      Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
20
Dr. Jiraporn Limpananont, Faculty of Pharmaceutical Sciences, Chulalongkorn University

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Jiraporn Limpananont - Ip Event

  • 1. IPR & Access to Medicines in Thailand  Dr. Jiraporn Limpananont Foundation For Consumers (FFC)   Drug Study Group (DSG)  FTA Watch  Social Pharmacy Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University. 1 Dr. Jiraporn Limpananont, Faculty of Pharmaceutical Sciences, Chulalongkorn University
  • 2. Scope: IPR & Access to Medicines IPR Protection: Patent Act   Raise up the innovation?  High price, un-affordable  Impact on the Generic Drug Manufacturing: destroy the local generic drug manufacturer  FTA and Trade Pressure: TRIPs Plus on IPR for drugs 3 Cases of consumers’ movement for Access to  Drugs”  Revocation: ddI case  Pre-grant opposition: combid case  CL implementation 2 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 3. Impact on Generics Industry R&D on NEW DRUGS R&D on RAW MATERIALS R&D on DRUG FORMULATION A+B X+Y FINISHED ACTIVE PRODUCTS INGREDIENTS Other materials PROCESS PATENT PRODUCT PATENT 3 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 4. IPR PROTECTION IN THAILAND Time Line •Drug Process Patent 2522(1979) •15 years patent life Patent Act: •Drug Product Patent 2528(1985) •20 years patent life USTR: •Group of pharmacists •Drug Product Patent 2535(1992) and friends •20 years patent life Patent Act: •Cary on research •Drug Patent Committee •Advocacy 2538(1995) •TRIPs •People Mobilization WTO: 2542(1999) •Abolish Drug Patent Committee Patent Act: FTA Coming •DATA EXCLUSIVITY soon?: •Limit CL implementation •Extension of Exclusity Period 4 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 5. Event on the 6th round of Thai-US FTA negotiation Chiamgmai, Thailand Jan. 2005 5 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 6. Case 1: Revocation of ddI patent ddI was invented by US NIH, licensed to BMS, and  not allowed to be patented in developing countries,  BMS did not patent ddI in Thailand but patented ddI formulation  ddI formulation is not new, no inventive step, but it was patented  The price is very high 6 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 7. Two ways of solving this problem Issue the CL since 2000   Result: no CL was issued Revoke the Patent   Result: BMS negotiated to end the case in the court by voluntary withdrew this patent 7 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 8. TPN+ Camp asking for CL on ddI patent 8 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 9. Case 2: Pre-grant opposition of combid Case:   GSK filed for the formulation of AZT 300 mg + 3TC 150 mg  AZT and 3TC were not patented in Thailand  They were already used, not new and no inventive step  The cheap generic version was sold  If it was patented then GSK can monopolize the market, the price will be very high Civil Society Movement to  Make opposition to this application  Result:   The process took more than 5 years  Finally GSK withdrew this patent application Strategies:   Put pressure on the unethical practice of GSK  Mass media campaign and demonstration 9 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 10. 10 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 11. Case 3: CL of Government Use 2 ARVs:   Efavirenz commercially known as Stocrin, of MSD (on 29 November 2006)  Lopinavir/Ritonavir commercially known as Kaletra, made by Abbott (on 24 January 2007) 1 Heart disease drug   Clopidogrel commercially known as Plavix, made by Sanofi-Aventis (on 25 January 2007) 11 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 12. Diagram to demonstrate that the Government Use of patent does not affect much on the existing market size of patented products % of population at each income level 62 million Thais Social Welfare = 48.5 million Social Security = 8.5 mil. Civil Servant Medical Benefit Scheme = 5 mil. Income Low High Out of People paid by public budget with no or pocket limited access to patented drugs – payment – “New market for drugs from “Existing market for high Government Use” price patented “Public non-commercial use” drugs” “Commercial use” 12 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 13. TRIPS flexibilities Permission Non Public use: Prior negotiation Royalty  Terms of use Voluntary licensing Compulsory licensing Public Use: No need for prior negotiation  Royalty National emergency Terms of use Extreme urgency Public non-commercial use (TRIPS 31(b): DOHA; Thai patent act section 46-52) 13 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 14. After negotiation for 1.5 Yr After CL Announcement MSD MSD - Efavirenz – 1723 to 1401 Baht - Efavirenz – Now is 770 Baht/Bottle (~18.7% reduction in Baht (~ 45% price reduction) because of the Baht appreciation: no reduction in terms of USD) Abbott Abbott - Strong reaction - 9 Dossier withdrew - Kaletra – 17548 to 6000 Baht (including Kaletra film-coated tab) (~66% reduction in Baht or - Kaletra – no WHO pre-qualified pdts ~57% reduction in USD) available (expected to be available in film- coated tab form in the next few months) Roche Roche - Saquinavir has no patent in Thailand, - Saquinavir – 4852.66 to 4601 but GPO is in the process of production Baht (~5% reduction in Baht or development. ~15% increase in USD) - Less used in National Health Program BMS BMS - Atazanavir (2nd line that can replace - Atazanavir – No price reduction Lopinavir) – will be negotiated for price reduction and/or CL 14 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 15. Reaction from USTR and Abbott Under Section 301, USTR put Thailand on the PWL   Abbott withdrew all applications to register its new drugs in Thailand 15 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 16. Reaction from Civil Society: boycott Abbott 16 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 17. Demonstration 17 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 18. Worldwide Boycott Abbott’s Products 18 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 19. Conclusion Patent in the field of pharmaceuticals:   Market driven R&D not Public Health Need driven R&D  No drugs for the treatment of the Poor's diseases  Patented drugs are un-affordable for the Poors What should we do for access to medicines ?  19 Dr. Jiraporn Limpananont, Chair, Foundation For Consumers, Thailand
  • 20. 20 Dr. Jiraporn Limpananont, Faculty of Pharmaceutical Sciences, Chulalongkorn University