In granting a compulsory licence to Natco on Bayer’s cancer drug Nexavar the patents office has done its job well. It has put a provision in the law meant expressly to balance public good with incentives for innovation to its right use. See Shamnad Basheer’s lucid analysis of the order on spicyip.
But it is important that this not be the predominant or only method deployed by the government to improve drug access and affordability to millions of Indians. Given its visibility, there is a danger of the patents and CL debate hijacking or at the very least taking up prime space in the discussions around the country’s healthcare agenda at the cost of other, less high-profile, measures that could be equally effective.
Historically, the Indian government has left it to the generic drug industry to bring down prices by providing a lax patents law (until 2005) but access and affordability have still been major issues. (Even now, Natco’s generic Nexavar will cost twice as much as the monthly income cut-off defined by the Indian government for below-poverty-line families).
This is because the Indian government has done little else such as updating the drug pricing system and regulations, or creating a transparent system of bulk procurement of quality drugs, or encouraging the switching of branded generics with cheaper yet quality unbranded generics in government hospitals. Nor has there been sufficient reform in the non-drug healthcare sector which accounts for a hefty portion of medical expenses.
I’d love to see patient advocacy groups and NGOs who have fought so admirably for a strong CL system in India, also put pressure on the government to do these other things (or their variations) that will go a long way in achieving universal healthcare. A recommended read is the Dr Srinath Reddy report on Universal Health Coverage for India delivered to the Planning Commission on November 2011 which has received less publicity than it deserves, in my opinion. See here. It has some sustainable solutions.
In the absence of a balanced holistic debate on healthcare it will be tempting for this and successive governments to fall back on old ways. Natco’s CL signals to those within and outside the country that India considers the health of its citizens paramount. But now that the patents office has sent out such a strong message other government departments must hunker down to take it to its logical conclusion.
As always, thoughts welcome.