Compromise is key to keeping drugs affordable

An Indian legal case shows the need for a middle way between the rights of prescription-drug innovators and the needs of the world's people.

The ruling by India's Supreme Court yesterday over a potent anti-cancer drug has demonstrated vividly the need for compromise between pharmaceutical research firms and generic producers.

Boiled down to its most basic, this is an issue of intellectual property rights versus access to cheap, effective and life-saving drugs. The world must find a way to reconcile the rights of the innovators who create our vital medications and the interests of populations, especially in poor countries, that are desperate for affordable care.

Glivec, a drug highly effective against one form of leukaemia and some other cancers, was developed by the pharmaceutical giant Novartis, and became available in 2001. Today it costs about Dh14,500 a month in many places. But a generic equivalent made in India costs just Dh640.

In its ruling, India's top court refused to give Novartis patent protection for a slightly-altered form of Glivec.

"Evergreening," the common practice of re-patenting almost-identical versions, abuses the spirit of patent law, but the industry says it is essential to recoup vast research costs. (Novartis, for one, is coping: operating income last year was $15.2 billion (Dh56 billion) on sales of $56.7 billion.)

The industry deploys both lawyers and lobbyists to defend its private property rights around the world. They argue, convincingly, that without profits there would be no incentive to develop the next "miracle" drug. Consider malaria: globally a malady of the poor, it attracts so little drug research that experts call it a "neglected disease".

On the other hand few governments will watch idly as their people die because generic drugs are banned. India has a large generic sector, and yesterday's decision means that generic drug makers can continue selling its copies of Glivec at low prices.

Generics are likely to increase their share of the world market. Beyond patents, there is already a mechanism - the World Trade Organisation's 1994 Trade-Related Aspects of Intellectual Property Rights accord - which under some circumstances allows a government to force a patent-holding company to licence a drug to a local producer. Last year Bayer, another "big pharma" company, was forced to licence Nexavar, a cancer drug, in India: the retail price fell by over 90 per cent.

Obviously there are moral and economic considerations pushing in different directions. But there is also a common human interest, in encouraging both new research and the easy availability of safe, effective drugs both old and new to all the people of the world. Compromises to create that situation are surely not beyond the scope of human cooperation.