Abbott's recent action to withdraw its drug applications from the government review process in Thailand, including an important new HIV treatment, is another example of the multinational pharmaceutical companies' overreaching interpretation of intellectual property entitlement when it comes to the developing world. The Thai government is allowing the sale of a locally produced AIDS drug developed by Abbott. The company alleges that the Thai government is exploiting World Trade Organization rules governing the local production and sale of patented drugs in a time of emergency. According to Thai statistics, one in 100 adults in the country is infected with HIV, and AIDS has become one of the leading causes of death. In a country of 65 million people, this is too significant a patient population to deny in the interest of making a point. AIDS not an emergency, in Thailand--in what world does Abbott operate?!
In an earlier blog, I told of Novartis' battle with the government of India over a related issue concerning the production of its Gleevec leukemia product. As these types of cases continue to mount, it becomes more and more difficult to portray these companies as organizations that are truly looking for solutions to global healthcare issues. This is particularly true as patient need increases and countries are willing to seek out new answers to provide for their people.
More than 30 of the United Nations' "Least Developed Countries" have joined the World Trade Organization and are eager to respect patent rights that allow them access to life saving medications. Yet in emergency situations such as with the global AIDS epidemic, it is irresponsible to bargain with the lives of those least able to fend for their own healthcare needs.
Additionally, Abbott's track record indicates that it will go to great lengths to defend its medicines from any competition. In the Jan. 3, 2007 issue of The Wall Street Journal, John Carreyrou discussed the company's strategy to increase revenues and stifle competition for Kaletra, its new AIDS therapy. A number of options surrounding Norvir, Abbott's established, but less profitable, combination drug were discussed, including pulling the therapy from the U.S. market and purposely manipulating inventories so that only a nauseating liquid formulation was available. Eventually the company opted to raise the price of Norvir by 400 percent, causing a shift to the new therapy, but making it more difficult for many patients to get or maintain the treatments they needed. Coupled with the recent Thailand conflict, I find it difficult to give Abbott the benefit of the doubt. Yet, once again, there is a solution.
Innovation in the pharmaceutical industry is critical to global healthcare. Companies such as Abbott can fulfill the needs of patients in developing nations and receive fair compensation with innovation in their business model as well as products. This requires partnering with the local companies that are interested in currently serving large populations in developing and emerging economies . These companies understand that there is an immense volume of patient need in the many developing and emerging economies whose scale, at a lower profit margin, provide the financial return needed to keep these therapies accessible on a sustainable basis to those who need them most--sustainable, because the companies are making a profit The business model innovation requires acceptance of the fact that tiered pricing must occur, and already is occurring, across nations with differing abilities to pay.
This type of cooperation in developing nations could make companies like Abbott pioneers of the new pharmaceutical industry that is again recognized for the good of discovering and delivering life-saving medications to address the world's unmet healthcare needs.