Five years after DOHA, drug prices are on the rise

Countries must make more use of TRIPS flexibilities

Drug prices are on the rise five years after the historic signing of the Doha Declaration on TRIPS (Trade Related Aspects of Intellectual Property Rights) and Public Health at the 2001 World Trade Organization (WTO) Ministerial meeting in Doha, Qatar, the international medical humanitarian organisation Médecins Sans Frontierès (MSF) stressed today. Getting drug prices to decrease will require countries to make more extensive use of the TRIPS flexibilities enshrined in the Doha Declaration, which sought to "... protect public health and (...) promote access to medicines for all."

The case of AIDS illustrates the trend. While fierce generic competition has helped prices for first-line AIDS drug regimen to fall by 99% from $10,000 to roughly $130 per patient per year since 2000, prices for second-line drugs - which patients need as resistance develops naturally - remain high due to increased patent barriers in key generics producing countries like India.

In a country such as South Africa, where MSF has been providing antiretroviral therapy for five years, treating 58 patients on second-line drugs costs the same as treating over 550 patients on first-line. In addition, newer HIV medicines that are recommended by WHO can cost up to 50 times more, if they are even available in countries. These drugs will be impossible to use unless generic competition drives down prices and helps increase availability.

"In our projects, we feel the effect of higher drug prices on our budget," said Dr. Tido von Schoen-Angerer, Director of MSF's Campaign for Access to Essential Medicines. "We're seeing many countries make use of the Doha Declaration to import medicines, but what is the use if soon there are no generics to buy? Countries where drug producers are based need to take steps to allow generic production and export of new essential medicines. If this doesn't happen we'll be back where we started in no time because treatment will become unaffordable again."

The report released in April by the World Health Organization Commission on Intellectual Property, Innovation and Public Health concludes that, contrary to what its proponents often claim, intellectual property protection has not led to increased innovation and access to treatment for people in developing countries.

"Time has come to rethink the way new medicines are developed and paid for. The current system based on patents and high prices to pay for innovation leads to rationing and leaves huge health needs neglected" said Ellen 't Hoen, Director of Policy & Advocacy at MSF's Campaign for Access to Essential Medicines. "The upcoming talks at the WHO on a action plan and framework for essential health research and development in December offer an opportunity to start this process."