Chalermsak Kittitrakul (Jockey) is the Executive Director of AIDS Access Foundation, our campaign partner in Thailand.
He explains why repurposed drugs are the best hope for treating COVID-19 in the short-term, and how corporations may benefit from fresh profits unless unethical practices are prevented.
To try to limit the catastrophic impact of COVID-19, a huge amount of funding has been invested into scientific development and trials around the world, in order to find ways to treat and prevent the coronavirus.
Being an emerging disease, solving the problem is like looking for a needle in a haystack. Around the world people have high hopes that a new vaccine or medicine will be a game-changer, turning the situation on its head. But it is not that simple. Generally, it takes years to develop a new, innovative vaccine or drug.
Despite the fact that there is not yet a medicine able to treat the COVID-19 infection effectively, a number of existing medicines, developed to treat other diseases, are being tested in clinical trials underway or being used in the treatment of COVID-19. It’s faster, and as they are existing, repurposed medicines, it should in theory be cheaper.
One of these medicines is favipiravir, which was originally invented for the treatment of influenza.
In Thailand, favipiravir has been used to treat people with COVID-19-and pneumonia, alongside anti-malarial and anti-retroviral medicines. During March and April 2020, Thailand imported over 150,000 favipiravir tablets from Japan and China (brand name ‘Avigan’), priced at $4 (USD) per pill. So far, hundreds of COVID-19 patients have received treatment free of charge.
Treatment guidelines in Thailand for people with COVID-19 and pneumonia currently state to prescribe favipiravir for 5-10 days, requiring a total of 40-70 tablets. The cost to the government to treat each person with the branded version is between $28-32 (USD) per day.
When you compare this to the fair price of production, arrived at by a research team at the University of Liverpool, UK, the difference is quite stunning. Using an established methodology, the researchers estimated costs for generic production (including allowing for a 10% profit margin) to be $1.45 per day. For countries needing to procure medicines at scale, this overpricing of around 20x is hugely significant.
FujiFilm Toyama Chemical has filed for patents on favipiravir in numerous countries, including three in Thailand. If approved, this would continue to block generic competition in Thailand until after 2031, as under Thai law, a patent’s duration is 20 years from the date the patent application was filed.
On 17 July 2020, AIDS Access Foundation filed a third party observation to oppose the patent application (no. 1101001988) filed for favipiravir in Thailand. Our team assessed the application and deemed it be unmerited on the grounds that the formulation techniques are not new and there is no ‘inventive step’. We are now reviewing FujiFilm’s other two applications.
If the patent office rejects the patents, the Government Pharmaceutical Organization (GPO), a state enterprise and a key local manufacturer in Thailand, would be able to produce and supply generic treatment at a significantly lower cost. GPO has already started the process of manufacturing generic favipiravir which it expects to be able to produce at a large scale by 2022.
COVID-19 a global threat, which needs a global response. Patents on drugs repurposed for treatment of the coronavirus should be prevented in all countries.
During this life-and-death scenario, it is outrageous for corporations to take advantage of the crisis to make money. Monopolising medicines is only going to deepen the negative impact. The pandemic has further highlighted the flaws of the patent system, clearly demonstrating how it is abused to the detriment of public health.