The proposals in the now-leaked Trans Pacific Partnership (TPP) trade agreement text go far beyond patents and exclusivity for drug data (delaying generics), but also make domestic drug reimbursement a matter of international law. The TPP would curtail the freedom of governmental health plans to negotiate or set pharmaceutical prices.
The US can’t come to a policy consensus in this area domestically, so setting global policy norms would seem to be a non-starter. Who would try use global trade deals to bypass national legislative processes in a contentious domestic area like health care reimbursement for drugs?
Start with President Obama, or at least his Office of the United States Trade Representative (USTR). From the Bangkok Post:
Mr Obama is now rolling back the Bush-era stance on medical patents. Mr Bush basically acceded to demands from developing countries, led by Thailand, for access to affordable medicines. It was Mr Bush who backed down when challenged by the Ministry of Public Health over drugs for Aids and heart disease. He accepted that the right to affordable medicine trumped strict patent enforcement. The new policy under Mr Obama specifically returns the right of “big pharma” to retain and expand its patent rights. That means a monopoly on any “new” drug and on all marketing. US negotiators at the past two TPP sessions threw these proposals on the table nonchalantly, as if they meant nothing. Civil society groups leapt on the issue, putting the entire TPP proposal at risk.
For details, see the 52 page report by academics at American, Yale and Northeastern, and the issue brief from Médecins Sans Frontières. For the record, I’m not opposed to making policy in this area, but this is being done in great secrecy, without any normal deliberative political process. We need transparency, not 18th century diplomatic models.