South-Western College Publishing - Economics  

Policy Debate: Should there be a shorter period of patent protection for prescription drugs?


 

Issues and Background

The overwhelming evidence from around the globe supports the thesis that the protection of private property is central to improving economic performance. This protection must extend to intellectual property and patents on drugs. Attenuation of patents therefore goes further than simply making developing country disease an unattractive avenue for pharmaceutical research and development; it undermines economic growth and human health.
~Roger Bate and Richard Tren

 

The inefficiency stemming from the patent is both large and indisputable. The most basic principle in economic theory is that goods should sell at their marginal cost of production (including a normal profit). In the case of patented drugs, prescriptions that are produced for as little as $1-2 each can sell for hundreds of dollars as a result of patent protection. The rationale for this gap is that the firm has to be able to recover its research costs, which are often quite significant.
~Dean Baker

 

Concerns over bio-terrorism during the Fall of 2001 raised questions in the U.S. and Canada about the length of patent protection for Cipro, the only medication approved by the Food and Drug Administration (FDA) for the treatment of inhalation anthrax. While there were many advocates in both countries for the elimination of this patent protection, both countries decided to maintain the patent (partially because low-cost generic alternatives such as penicillin were known to provide alternative effective treatment for this illness). The high cost of effective medications for malaria and AIDS have also lead to calls for a relaxation of patent protection for these medications in low-income African countries.

Under current patent law, the patent holder for a pharmaceutical product has the exclusive right to supply the product for 20 years from the granting of the patent. One problem with this, from the perspective of the pharmaceutical companies, is that the 20-year period begins with the granting of the patent, not with FDA approval of the drug. As the time required for drug approvals lengthened substantially due to requirements for more elaborate clinical trials, the period of market exclusivity provided by the patent declined. The Hatch-Waxman Act of 1984 provided an extension to the patent period equal to one-half of the time from the beginning of clinical trials to the end of the drug approval process. This extension can last for at most five years and the total period of market exclusivity cannot exceed 14 years. To receive this extension, a pharmaceutical company must display "due diligence" in the approval process.

Since patent protection provides the company holding the patent with some degree of monopoly power, the price is higher and the level of use is lower than it would be in a competitive market. Patents exist, however, because there would be no incentive for firms to engage in research and development of new drugs if patent protection did not help to ensure a return that is large enough to make this risky venture profitable.

A difficult tradeoff faces society in determining the length of patent protection for prescription drugs. A shorter period of patent protection results in lower prices and higher levels of use for medications that improve the quality of life (and often help to extend lifespans). A reduction in the length of patent protection, however, would also be expected to result in the development of fewer medications. An increase in the length of patent protection would increase the incentives for research and development, but would make medications more difficult for patients to afford.

Once the patent for a prescription drug expires, other companies may submit generic equivalents to the FDA for approval. When a generic equivalent to a particular medication is approved, it receives 180 days of market exclusivity before any other generic equivalents to this medication are allowed to enter the market. The purpose of this 180-day market exclusivity period is to provide a return on the cost of the drug approval process.

Patent protection is not always a sure means of maintaining a monopoly during the life of the patent. Once a new drug appears on the market, other drug companies are often able to engage in a reverse engineering process that allows them to develop products with similar therapeutic benefits that are sufficiently different chemically to not violate the original patent. It is quite common for the development of a new product to result in the release of several other similar products within a few years. This results in a significant reduction in the return that will be received by the original developer.

Prescription drug prices have been increasing more rapidly than the overall increase in medical costs. As the population ages, the share of GDP devoted to pharmaceutical products is likely to continue to expand. It is quite likely that drug company patents and profits will continue to be an issue of concern for the next several decades.

 

Primary Resources and Data

  • Food and Drug Administration
    http://www.fda.gov/
    The Food and Drug Administration (FDA) is the U.S. federal government agency charged with approving the use of prescription drugs for specific applications. The FDA website contains an extensive collection of information about new drug treatments, research studies, and other related issues.

  • Center for Drug Evaluation and Research
    http://www.fda.gov/cder/
    The Center for Drug Evaluation and Research is the part of the FDA that deals with prescription drug approvals. This website contains information about specific drug approvals, research studies, and a useful description of the drug approval process.

  • United States Patent and Trademark Office
    http://www.uspto.gov/
    The U.S. Patent and Trademark Office website provides extensive information on the patent process in the U.S.

  • Canadian Drug Manufacturers Association, "Brand Name Drugs vs. Generic Drugs: What’s the Difference?"
    http://www.cdma-acfpp.org/en/resource/if_brandvsgeneric.shtml
    This online document, provided by the Canadian Drug Manufacturers Association, contains information on the relationship between generic and brand-name drugs. It is noted that generic drugs are used to fill over 40% of all Canadian prescriptions. (This document is in Microsoft Word format and may be read only if Word or an appropriate viewer program is installed on your computer.)

  • Gerald J. Mossinghoff, "Overview of the Hatch-Waxman Act and its Impact on the Drug Development Process"
    http://www.fdli.org/pubs/Journal%20Online/54_2/art2.pdf
    Gerald J. Mossinghoff, in this 1999 article appearing in the Food and Drug Law Journal, provides a detailed history and a discussion of the key provisions of the Hatch-Waxman Act. This Act provides for an extension of the length of patent protection to compensate for time spent during clinical trials and the new drug approval process. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • Prescription Drug Pricing Pathfinder, "Statutory Protection"
    http://www.law.berkeley.edu/library/classes/alr/pathfinerexample2/StatutoryProtect.html
    This webpage provides a useful overview and history of the patent law affecting prescription drugs.

 

Different Perspectives in the Debate
  • Roger Bate and Richard Tren, "Malaria and Patents"
    http://www.policynetwork.net/uploaded/pdf/rethinking_the_debate_0701.pdf
    In this July 2001 article (beginning on p. 6 of this document), Roger Bate and Richard Tren examine the effect of patent protection on the treatment of malaria. They note that malaria remains the leading cause of death among the worlds' poor. While chloroquine, a low-cost generic drug, is still somewhat effective in treating malaria, parasites have begun to develop a high level of resistance to this drug in many regions. High levels of resistance are also beginning to appear for other low-cost treatments. The most effective treatments are relatively expensive since they rely on patented medications. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

    Bate and Tren note that a lack of patent protection in Thailand and India has reduced the profitability of patented anti-malarial drugs. They observe that only 5 of every 5000 medications tested are submitted for clinical trials and only 1 of these (on average) will be approved. These high investment costs can be covered only if effective patent protection is provided. Roche has ceased development of anti-malarial drugs because of the low return that it has received on its earlier investments. Bate and Tren argue that the protection of patent rights is essential for the continued development of effective drug therapies.

  • Pharmaceutical Research and Manufacturers of America
    http://www.phrma.org/
    The Pharmaceutical Research and Manufacturers of America represents U.S. pharmaceutical companies and biotechnology companies. This web site contains information about the views of the pharmaceutical industry on a wide variety of policy issues (at the international, federal, and state levels). This site provides information on the cost of prescription drug research, development, and approval. Information on new drugs under development is also provided at this site.

  • Dean Baker, "The Real Drug Crisis"
    http://www.cepr.net/columns/baker/1999_08_21.htm
    Dean Baker examines the effect of patent protection for prescription drugs in this July 25, 1999 online article. While he recognizes that there is a need to compensate firms for research and development spending, Baker suggests that the current system of patent protection is highly inefficient. He argues that this system results in prices that substantially exceed marginal costs and provides incentives for further inefficiency in the form of rent-seeking behavior. It also provides firms with an inefficient incentive structure that encourages them to duplicate the research efforts of other firms. Baker argues that alternative methods of funding research should be given serious consideration. He also suggests that there are substantial equity issues associated with trying to impose the U.S. patent system on low-income countries.

  • Dean Baker, "Drug Prices in Crisis: The Case Against Protectionism"
    http://www.dollarsandsense.org/archives/2001/0501baker.html
    Dean Baker argues against the current system of patent protection in this May 1, 2001 online article appearing in Dollars and Sense. He suggests that patent protection is a form of protectionism and results in the same inefficiencies as other forms of protection. Baker indicates that the package of anti-viral drugs used to combat AIDS in the U.S. costs approximately $10,000 a year, but could be produced for approximately $350 a year in countries that do not enforce patent protection. Baker believes that the current system of patent protection substantially harms consumers and distorts incentives.

  • Avert, "TRIPS, AIDS, and Generic Drugs"
    http://www.avert.org/generic.htm
    This online document describes the Trade-Related aspects of Intellectual Property Rights (TRIPS) agreement that requires all WTO members to esnure that intellectual property rights are respected by countries engaged in international trade. It is noted that exemptions had been provided for some AIDs drugs so that generic substitutes could be produced at low cost as long as they were initially patented prior to the 1995 introduction of TRIPS. Drugs introduced after this time may have generic substitutes available only under a compulsory licensing system. While this arrangement is usually used only when the manufacturer cannot meet demand for a pharmaceutical product, an exemption has been granted for many AIDs drugs provided to individuals in low-income countries. This document describes bilateral "TRIPS Plus" treaties negotiated by the U.S. with other countries to provide greater protection for U.S. intellectual property rights than those that are provided under TRIPS.

  • Michael R. Kremer and Christopher M. Snyder, "Why is There no AIDS Vaccine?"
    http://www.economics.harvard.edu/faculty/kremer/papers/vac36_9June06.pdf
    In this June 2006 working paper, Michael R. Kremer and Christopher M. Snyder examine the relative profitability of AIDs treatment drugs and a potential AIDs vaccine. Their simulations suggest that the generated generated by treatment drugs is substantially greater than that which would be generated by a vaccine. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • Ernst R. Berndt, Rachel Glennerster, Michael R. Kremer, Jean Lee, Ruth Levine, Georg Weizsacker, and Heidi Williams, "Advance Market Commitments for Vaccines Against Neglected Diseases: Estimating Costs and Effectiveness"
    http://www.economics.harvard.edu/faculty/kremer/papers/AMCHealthEconomicsFinal.pdf
    In this 2006 working paper, Ernst R. Berndt, Rachel Glennerster, Michael R. Kremer, Jean Lee, Ruth Levine, Georg Weizsacker, and Heidi Williams examine the possibility of an advance commitment by one or more government sponsors to guarantee a minimum price paid per person immunized in low-income countries. They note that such an arrangement lowers marketing costs for the developer of a vaccine. Simulations provided in this study suggest that this could be a cost-effective method of reducing HIV/AIDS, malaria, and tuberculosis infections in low-income countries. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • Pfizer Pharmaceuticals Group, "Pricing and Value: Drug Spending and Utilization"
    http://www.pfizer.com/pfizer/policy/drugcost.jsp
    In this February 2006 online article, Pfizer Pharmaceuticals provides its views on the high expenditures on prescription drugs. It is noted that most of the increase in expenditures on prescription drugs is due to an expansion in the use of prescription drug treatments, not the result of increases in the price of medications. They argue that the discovery of many new effective drugs have improved the treatment of many types of illness.

  • Harvey E. Bale, Jr., "Patent Protection for Pharmaceuticals: A Platform for Investment, Markets, and Improved Health in the Americas"
    http://www.sice.oas.org/ip/Phrma_e.asp
    In this March, 1996 paper, Harvey E. Bale, Jr. provides a case for patent protection for prescription drugs. He notes that those countries that do not have effective patent protection for prescription drugs have low levels of research and development in the pharmaceutical industry. They also tend to have relatively high rates of illness.

  • CBS News - 60 Minutes, "Insider's Rx For Drug Costs"
    http://www.cbsnews.com/stories/2005/06/03/60minutes/main699606.shtml
    This June 5, 2005 document summarizes many of the issues associated with rising drug care costs. A discussion of the arguments for and against re-importation of drugs is provided.

  • Bureau of Competition and of Policy Planning, Federal Trade Commission, "180-Day Generic Drug Exclusivity for Abbreviated New Drug Applications: Comment"
    http://www.ftc.gov/be/v990016.htm
    In this November 4, 1999 document, the staff of the Bureau of Competition and of Policy Planning of the Federal Trade Commission discuss the need for a "use it or lose it" provision for the 180-day exclusivity period for new generic drug equivalents. It is argued that this revised FDA rule would result in more rapid introductions of new generic drugs and would benefit consumers.

  • Biotechnology Industry Organization (BIO), "Statement Submitted to the Subcommittee on Courts and Intellectual Property"
    http://www.bio.org/ip/positions/tstm070199.asp
    In this July 1, 1999 statement, the Biotechnology Industry Organization argues that the Hatch-Waxman Act should be amended to provide a day-for-day extension of patent protection to compensate for the lost marketing time as a result of clinical tests and the drug approval process. It is argued that such an extension will result in the development of more effective treatments for cancer, diabetes, Alzheimer's and Parkinson's diseases, and arthritis.

  • August 4, 1999 Statement of Senator Patrick Leahy
    http://judiciary.senate.gov/oldsite/8499pjl2.htm
    In this statement, Patrick Leahy argues against an extension of the patent for Claritin and other "pipeline drugs." He notes that these drugs had already received patent extensions under the General Agreement on Tariffs and Trade and as a result of the Hatch-Waxman Act. Leahy suggests that policies should be made for all firms, not on a case-by-case basis.

  • Bob Carlson, "Oregon Attempts to Blaze Trail with 'Reference-Based' Formulary"
    http://www.managedcaremag.com/archives/0107/0107.oregonforumlary.html
    In this July 21 Managed Care article, Bob Carlson examines a prescription drug cost-containment program that is under discussion for Oregon's Medicaid program. Under this plan, the state would adopt a formulary consisting of an approved list of drugs that are both clinically and cost effective. Those using drugs that are not on the formulary would have to pay the difference between the approved medication and the prescribed drug.

  • Minority Staff, Committee on Government Reform, U.S. House of Representatives, "Prescription Drug Prices for Uninsured Seniors in the U.S. are Higher than Prices in Canada, Europe, and Japan"
    http://www.democrats.reform.house.gov/Documents/20040628104816-38372.pdf
    This June 2003 staff report discusses the result of a study of prescription drug prices in the U.S., Canada, Europe, and Japan. It is found that the average cost of commonly used prescription drugs is, in many cases, twice as high as in other industrialized economies. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • India Knowledge@Wharton, "What's Behind U.S. Drug Companies' Response to the AIDS Crisis Abroad?"
    http://knowledge.wharton.upenn.edu/india/...5389664
    This online article discusses the actions taken by U.S. drug companies in dealing with the AIDS crisis. It is noted that several U.S. drug companies have begun to supply AIDS medications at substantially reduced prices in low-income countries. It is suggested that these actions are partially the result of an attempt to avoid further negative publicity and also a way of dealing with competitive threats from generic drug producers in countries such as India that do not enforce U.S. drug patents. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • WHO/WTO Workshop on Differential Pricing and Financing of Essential Drugs
    http://www.wto.org/english/tratop_e/trips_e/hosbjor_presentations_e/hosbjor_presentations_e.htm
    This page contains links to the texts or PowerPoint slideshows used by participants in the April 2001 WHO/WTO Conference on Differential Pricing and Financing of Essential Drugs. This conference addresses the issues concerning access to expensive drugs in low-income countries that face serious health problems. The extensive materials provided on this website provide useful information on the effect of patent protection on drug availability and pricing in both high-income and low-income economies.

  • Robert M. Goldberg, "The War Against Cipro: Schumer's biofoolishness"
    http://www.nationalreview.com/comment/comment-goldberg102501.shtml
    In this October 25, 2001 National Review article, Robert M. Goldberg provides an argument against the earlier termination of Cipro's patent. He notes that there there are many low-cost generic drug treatments that are effective against anthrax. Goldberg argues that the early termination of patents reduces the incentive for firms to engage in research and development.

  • Council on the Economic Impact of Health System Change, "The Economics of Prescription Drug Pricing"
    http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=188
    This website contains audio, video, and slide presentations from a March 28, 2001 conference at the National Press Club. The arguments presented at this conference provide a nice overview of the major arguments involving the effect of patent protection on prescription drug prices.

  • Donald J. Sutherland, "The Continuing Rise in Prescription Drug Expenditures"
    http://www.socioeconomic.org/Publications/Perspectives/drugprice.pdf
    Donald J. Sutherland examines the causes of the rise of prescription drug expenditures in this June 2001 online paper. He notes that prescription drug prices have increased by over 12% in seven of the thirteen years through 2000. Sutherland notes that this increase has been, in large part, the result of due to increased use of drug therapies and a switch to newer and more expensive medications. While prescription drug expenditures have been rising, many of these new drug treatments have resulted in overall savings in health care costs. He notes that this has been particularly true in the treatments for "ulcers, schizophrenia, asthma, strokes, migraine headaches, and kidney disease." Sutherland argues that the expenditures on prescription drugs should be evaluated in terms of their overall effects on health care costs. (The Adobe Acrobat viewer plugin is required to view this document. You may download this viewer by clicking here.)

  • Doug Bandow, " Demonizing Those Who Cure Us: The Drug Debate."
    http://www.nationalreview.com/comment/comment-bandow072403.asp
    Doug Bandow, in this online July 24, 2003 National Review article, argues that higher prices for drugs in the U.S. is the result of the high effectiveness of newly developed drugs. He argues that attempts to lower drug prices would reduce the incentives for innovation that have resulted in many lives being saved.

  • Anna Cook, "Why Different Purchasers Pay Different Prices for Prescription Drugs"
    http://aspe.hhs.gov/health/reports/Drug-papers/CookPricingMemo-final.htm
    In this memorandum, prepared for the Department of Health and Human Services, Anna Cook examines the nature of price discrimination in the market for prescription drugs. She observes that the monopoly power created by patent protection allows for the existence of price discrimination. Under this system, the highest prices are paid by uninsured individuals. This often means that those with relatively low incomes pay the highest prices for prescription medications.


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