Our partner’s work is focused on addressing the shortcomings in Thailand’s patent law and opposing unmerited patents, fighting against a tide of patent abuse which makes essential medicines unaffordable.
Evergreening, the practice of applying for overlapping patents on the same drug, which extends a company’s monopoly, is all too common in Thailand. In an 11 year period, 74% of patents granted were ‘evergreened’. In one case, there were six patents, and a total monopoly period of 31 years – on one drug. Shortcomings in the current patent law allow for this practice which severely impacts on public health.
This abuse of the patent system keeps the prices of medicines high. People living with HIV, Hepatitis C, and TB in Thailand are eligible for free treatment, but the financial pressure put on the health system by unmerited monopolies makes that difficult to fulfil. Evergreening significantly delays the entrance of more affordable generics by blocking competition. It means that older, less optimal, medicines are often procured and prescribed, as a cheaper alternative, to the detriment of people’s health.
An estimated 440,000 people are living with HIV in Thailand, with 72% treatment coverage. Over three-quarter of a million people are living with Hep C (759,000). The cost and complicated access route to a diagnosis are barriers, causing a bottleneck of people waiting for Hep C treatment. Pan-genotype direct-acting antiviral (DAA) treatment would reduce the number of tests required, although there would still be a number of barriers to overcome.
Less than half of people living TB are on treatment (59,000 people out of an estimated 130,000), and there are just over 2,000 cases of multi-drug resistant (MDR) TB each year.
Another issue that presents a barrier to access is a lack of registration of both original and generic medicines.
Additionally, a number of free-trade agreement negotiations include provisions to create stricter intellectual property (IP) regulations, as FTAs typically attempt to build in favourable terms for profit-making corporations. These clauses must be rejected in the interest of public health, or the situation in Thailand will be further exacerbated. Our partner, the AIDS Access Foundation (AIDS Access), also believes that corporations are aggressively lobbying the Thai government ‘behind closed doors’ to ‘legitimise’ patent abuse.
Our partner, the AIDS Access Foundation (AIDS Access), is striving to make medicines affordable and reduce the pressure on Thailand’s health budget, so people can access optimal treatment.
It’s a challenging context to work in, and achieving change requires sustained effort and simultaneous actions. For example, previous successes, such as including more HIV ARVs and sofosbuvir (for Hep C) in treatment guidelines, required a multi-layered approach. Actions included filing patent oppositions, creating demand by advocating with doctors and patients, building the capacity of HIV networks, keeping dialogue with policy makers constantly open, and having representation among decision makers.
AIDS Access’ priorities for 2019 include:
- The ultimate goal is to prevent unfair monopolies, introduce more competition, and achieve fairly priced medicines so that universal access can become a possibility in Thailand. AIDS Access will continue its advocacy and dialogue with government, and providing evidence that convinces policy makers to make long-term, pro public-health decisions.
- AIDS Access will continue to oppose unmerited, evergreening patents, that are costly both to the health budget and human life. Patent oppositions are challenging in Thailand. There is a short window for pre-grant opposition, plus several shortcomings in the current patent law, including the vague patentability criteria and a lack of transparency of the examination process, make it difficult to use patent opposition effectively.
- Patent law reform is a priority, partly because of the challenges with patent oppositions, but also because a positive, permanent change to the law, could prevent unmerited patent applications in the future, and therefore the need for oppositions. The Department of Intellectual Property (IP) is currently proposing its draft patent law amendment to the government. Concerns raised by civil society have not been taken into account in the latest draft. Gaps in patentability criteria and the limited of the use of oppositions still remain. AIDS Access’ public advocacy and dialogue with decisions makers aims to mitigate the risk of further monopolies.
- Preventing further ‘backwards’ steps. Ongoing FTAs and FTA negotiations with Thailand contain TRIPS Plus provisions. AIDS Access is providing the counter-arguments, urging for the prevention of clauses in FTAs that would stop Thailand using its legitimate rights or flexibilities as laid out in the TRIPS Agreement.
- Increasing access to optimal HIV treatment. AIDS Access is working with partners and other civil society organizations to bring more optimal HIV treatment regimens to Thailand, including dolutegravir. It is recommending that DTG is recommended as an option for first-line therapy (in addition to second- and third- line), for it be included in the country’s health care schemes, for generic versions to be registered in Thailand, and for a fair price to agreed on so that rollout is achievable.
- Closing the Hep C treatment gap. Our partner is equipped to take on this uphill struggle, tackling the multiple barriers to achieving a fair price for optimal treatment. The issues currently preventing this include: unmerited patents; cost of diagnosis; a lack of generic pan-genotypic regimens; and a lack of registration and competition of generic suppliers. In the case of SOF and SOF/LDV for example, one generic supplier exists, which means prices aren’t low as they should be. In the case of SOF/VEL, generic registration is required.
- Averting a TB crisis. AIDS Access is concerned about a potential TB crisis in Thailand. MDR TB is an issue and there is a lack of new effective medicines. Bedaquiline and delamanid, essential drugs in the treatment of MDR TB are not registered in Thailand, and their patent status is unclear. The drugs entered the global market at exorbitant prices. AIDS Access is working to identify the patent status of the drugs and will oppose unmerited applications if necessary. The organization is also raising awareness to increase demand and pressure to make these drugs available.
Last updated May 2019.