I too think India should be able to do whatever it wants to do with regards to its patent laws and such. Maybe it doesn’t respect patent laws for intellectual property that they value is irredeemably important to society or some such.
Clearly.
Dubious. India is a member of the World Trade Organization. The US says India has violated WTO agreements. India, of course, says it hasn’t.
I tend to agree that India has violated the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). India made an agreement that the preservation of intellectual property is a core value that it, as a member of the WTO, adheres to. They are in violation of that agreement and if they want to own that violation, they need to resign their membership in the WTO.
Begging the question and appeal to emotion in one sentence. Well done.
I agree. What India shouldn’t be able to do is to remain a member of the World Trade Organization and receive the benefits of that membership while ignoring the responsibilities. What are your thoughts regarding their WTO status?
My thoughts are that the WTO should decide if they are better off with the world’s largest democracy in the organization, or not.
We have a winner.
If the Republic of India is so keen on its citizens getting this drug, why don’t they pony up some goddamned money and buy it? Maybe cut back on a nuclear weapon or three.
I agree that the WTO should kick India out if they are violating rules needed to maintain membership. I have no idea how the WTO functions but I assume it would be up to a vote of a council of members. India should argue its case for why it should stay, and the US and Germany or whoever else can make arguments against them, and then they should take a vote.
Unfortunately I don’t know anything about WTO and how it functions and what benefits it endows and what responsibilities it holds its members to.
I’d feel a little more comfortable with Bayer developing the medicine for people who have the form(s) of cancer that it is used to treat. The way Herr Dekkers puts it, it sounds like Bayer is incentivized to give cancer to Westerners who can afford $69K.
And that’s basically what the Ontario model is.
ETA: Not always perfect, and disagreements occur, but that’s what we do.
Until Genentech came along, there was no drug to promote the production of red blood cells in the marrow (epigein… something - see Lance Armstrong). This was a huge problem for those with kidney failure - the kidneys usually produce that trigger.
Geneneech came up with 3 drugs, mostly referred to a “Epigen”, the name of the first or best known.
As I am looking at this stuff, the cost is of interest - $2600/week.
Now you know why Medicare picks up the bill for “end stage renal failure”, even if the patient does not qualify for Medicare.
I’m siding with BAYER on this one - those drugs are obscenely to develop - just the certification in the US costs millions.
Nobody else get to manufacture it - it would be nice if BAYER would make available at (marginal) costs to the destitute, but for India to say their labs can produce as much as they want, of whatever they want is completely unreasonable. If they ever do so, I would support a complete embargo of drugs and their formulas until the patent expires.
The WTO won’t kick India out and they won’t resign. As Fear Itself implied, India is poised to become a dominant economy on the world stage in the relatively near future. My allusions to them resigning or being dismissed from the WTO were mostly hyperbole. India may be persuaded to revoke the compulsory licence it granted to Natco, but I wouldn’t bet on it.
Mostly, it just seems extremely short sighted to me for India to so publicly flout WTO conventions regarding intellectual property, especially in the pharmaceutical industry where they are so well positioned to become a dominant player. The pharmaceutical manufacturing capabilities in India are immense. They don’t have a pharma R&D company in the top 50 worldwide, but damn, they are making some drugs! It’s probably inevitable that R&D will become an important part of their pharma portfolio sooner than later.
India is being petulant in regards to this Nexavar case. As DSeid mentioned, it’s a fairly smallish market and if worldwide use is at 15,000 annual patients, statistically that means India has about 2,600 patients that would benefit from Nexavar. At $69k per patient year, $180 million is nothing to sneeze at, but is India really trying to not pay $180 million to Bayer to save the lives of Indian citizens or is there an ulterior motive here?
This is the thing I have a problem with. India is giving public sanction to a private company to manufacture a niche pharmaceutical with an enormous (apparent) profit margin. It’s not about Indian citizens dying in the streets of liver and kidney cancer, as The Second Stone would have you believe.
Thanks Jake for your analysis. I agree that India would be better off just paying Bayer for it rather than flout the WTO rules and agreements. But if they can get away with it without getting kicked out or suffering punishments, embargos, sanctions or whatever, I can understand why they would want to do so.
Maybe a minor quibble here, but “theft” and “steal” are not the right words to use here.
Copyright infringement may be illegal, but it’s not theft.
Not seeing how that math works. The 15k patients (as calculated by DSeid, not an official number) are going to be mostly in the developed world, as that’s the only place people can afford such an expensive drug. That’s also ignoring those in the developed world that can’t afford 70 grand a year, who lack insurance, or whose insurance won’t cover the drug. I see little reason to believe that more than a billion or so people who would benefit from the drug would be able to obtain it. That would put India’s potential number of patients at about 15k as well, and up their bill to nearly a billion.
This is entirely speculative, of course, but I believe my assumptions are more plausible than yours.
From discussions on another board about this, I gather that:
[ul]
[li]According to Indian law, if a pharmaceutical company abuses it’s exclusive rights to make and sell a drug by price gouging, it’s legal for those rights to be taken away. It’s also legal under international law.[/li][li]Bayer has a reputation as outright monsters in much of the world due to them deliberately selling AIDS-contaminated medicine (because it was cheaper) back in the 80s on a large scale, and they aren’t going to get much sympathy outside the West. Not even if India was sending assassins after Bayer executives, much less just making a drug.[/li][li]India is already the source for most of the medicine used in the Third World.[/li][li]India is a large and relatively powerful country, and a strategically important one. Which means it can pretty much do as it pleases.[/li]Modern IP laws are stifling innovation, not promoting it.[/ul]
DSeid was working from reverse math of revenue versus patients and I extrapolated the worldwide need based on his worldwide use model. Completely fallacious on my part and you’re entirely correct to call me on it. I couldn’t have been more wrong.
If anyone has relevant numbers regarding worldwide demand irrespective of price, I would be interested in hearing them.
Bayer is a pretty evil corporation, even by German cooperating with Nazis corporation standards. Bayer - Wikipedia has a really toned down version. This particular gouging of the dying is actually morally above their usual practices.
Possibly relevant and I would be interested in more information regarding how India or any other country determines fair market price for products with multi-billion dollar R&D cycles produced by companies with R&D cycles that regularly result in multi-million or multi-billion dollar losses. Please cite relevant Indian and “international law”.
Irrelevant. Reputation is not legally significant to anything.
Irrelevant. Define the source. Is the source the manufacturer or the inventor? Right now, how many prescription drugs would India be able to manufacture without benefit of R&D done outside of India?
This has been discussed already. While true, this is irrelevant to the philosophical debate.
If true, this isn’t even remotely relevant to pharmaceutical R&D. If you care to make a contrary argument relevant to the discussion we’re having rather that spouting “IP laws are bad” feel free to dig in.
Your post doesn’t say anything. These are the things you “gather”? Bunch of useless drivel. It reads like it was built from a template of “How to construct an email full of made-up bullshit to send to all of your relatives who already filter your email to their trash folder, using bullet points.” The only remotely interesting thing you mentioned was legal precedent to nullify patent rights if the patent holder is judged to be abusing their rights. If you want to expound upon that point, I’m interested in hearing it. The rest is dreck.
Honestly the fact that a market exists or this med at all is illustrative of how our healthcare system bears a lot of expense to extend life by small amounts. Its indications again are unresectable liver cancer and advanced kidney cancer. It’s efficacy on overall survival (OS)?
So my calculations are likely slightly wrong: people are not on it for a year, they don’t live so long. On average it extends life for an additional 3 months in unresectable liver cancer but they still die in under a year.
Oh for kidney cancer it showed no statistically significant effect on overall survival at all but did demonstrate longer time of “progression-free” by an average of about 2 months.
Yeah, considering these outcomes as clinically worth much (rather than statisitically significant) is a Western medical market mentality.
We pay for it though. Both diluted via insurance and in families going bankrupt dealing with the bills. Not sure we can’t spend that money in ways with lots bigger impact on health. Just sayin’
Meanwhile I wonder if for resectable liver cancer India has surgeons do the operations for no money (or $177 per case, operating room expenses included)?
At least resectable offers a chance at cure.
Pretty sure that if you are poor in India you won’t be getting the surgeon operating on your curable resectable liver cancer. The surgeon won’t do it for $177. Doubt they end up with much care at all. Given that
Average per capita income in India with which to buy that health care, along with housing, food, etc? $1219. The poor in India are not spending $177 to extend life by 2 months let alone in order to achieve 2 additional months of tumor free survival with no impact on overall survival time. The probably are not seeing the doctor very much let alone a cancer specialist.
We know how to prevent most liver cancer, btw - Hepatitis B vaccine. If only the Ministry of Health bothered to distribute enough of it.
I think the high ground here is in short supply. It seems unlikely to me that India is so concerned about treating their own poor with this drug as they are with allowing Indian companies to benefit from others R&D investments.
Exactly. India is the 10th largest economy in the world, and whilst many Indians are extremely poor the country itself isn’t, and could easily pay if it chose. If a country the size of India refuses to pay for the R&D of medicines it’s citizens use, there will be fewer new medicines for anyone, including them. They are attempting to help relatively few people in the short term at the expense of billions in the future.
Calling it “price gouging” and calling the pharmaceutical companies “evil” is just stupid, but then anti-capitalist types have shown repeatedly that they are ignorant and know no better.
I’m reluctantly agreeing that the asshole has a point. Just like I should not be applied to rip DVDs and sell the movies as my own work, and like like I should not be able to scan novels and sell them on my own illicit Amazon, Indian companies should not be able to profit off of the hard work of others by simply copying their successes. $69,000 grand for a drug is pretty ridiculous, though.
If India were to be found to violate WTO standards on intellectual property, they wouldn’t be thrown out of the organization. Other countries would have an opportunity to levy punitive tariffs on Indian exports, most likely. Could you imagine what would happen if software developed in India were subject to a 15% punitive tariff?