Within the last few days, Raphael Correa, the president of Ecuador, made a statement encouraging domestic pharmaceutical companies to ignore drug patents and produce drugs that are still protected by international agreements. He said that this move was “in the name of human health.” Certainly, his thought is that by allowing local companies to manufacture drugs that are currently on patent in country, prices will decrease dramatically for sick Ecuadorians. As of now, there has been little comment from the major pharmaceutical companies, most likely because the country of thirteen and a half million people represents a small drop in the bucket of drug expenditures. Nevertheless, I would expect some generalized outrage from the companies if only because of the signal it sends to other nations considering similar moves.
At first glance, I thought that this move was generally a reasonable one. After all, our own personal experience revealed that the Ecuadorian people desperately need access to reasonably priced medicines. We saw how many sick individuals would pay for medication by the pill at the local pharmacy and quit when the symptoms subsided. Many more would not even buy the pills at all, letting the disease linger. Surely if the local pharmacies could sell locally manufactured medications at a discounted (generic) price, more people would be able to afford complete courses of treatment. Ultimately, this would lead to a healthier and more productive Ecuador.
After further consideration, I began to question such a policy. First of all, the only drugs that this would affect would be those that are on patent. Of the most commonly prescribed drugs, very few of them do not already have generics available or have generic alternatives available. In Ecuador, many of their problems are with GI or parasitic infections. Most, if not all, of the drugs to treat these conditions are already off patent. The drugs that are still on patent, are often minor adjustments to preexisting drugs marketed for the sole purpose of extending the drug companies monopoly on the medication.
Therefore, I question how much of an effect on prices and affordability this move will have. Sure, local pharmaceutical companies can begin to offer new, ‘state of the art’ drugs like losartan at reduced prices in the country, but does this significantly improve a country whose major cause of life years lost is lower respiratory infections ? Does this affect the average Ecuadorian who could use a prescription for an NSAID for his chronic back pain from working in the fields all day? More research into how much the ignoring of patents will affect the survival and morbidity of the average Ecuadorian is warranted.
If anyone is greatly affected by this, it will probably not be the average low class Ecuadorian who needs affordable access to antibiotics and antiinflammatory drugs. Rather, it is the upper class individuals in the private clinics whose problems closely mirror the medical problems in the more developed parts of the world: diabetes, hypertension, and heart disease. The medications for these ailments are the ones that still on patent because they are the ones that make the most money for the pharmaceutical industry. Therefore, I am afraid that this move by Correa, which on the surface seems to be for the health of all Ecuadorians, is really just a mechanism by which medical, social, and health inequalities in the country will be perpetuated.
By Sean Boley, MSII
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