India takes on drug makers in drive to cut healthcare costs
Pharmaceutical firms fear the repercussions of New Delhi’s search for generic treatments and its attitude to patents
Neelam Gupta, a breast cancer patient, is examined at an outpatient clinic in New Delhi. The decision of the manufacturer of Herceptin, a costly yet effective treatment for an aggressive form of breast cancer, to surrender its patent in India has raised concern that such moves threaten the global system for finding cures. Photograph: Lynsey Addario/New York Times
Ranno Trivedi, a breast cancer patient, rests at the metro station near her hospital while waiting for a blood test in New Delhi earlier this month. Photograph: Lynsey Addario/New York Times
Sarika Jain, a breast cancer patient who has had a mastectomy, waits to be checked by nurses at an outpatient clinic in New Delhi earlier this month. Photograph: Lynsey Addario/New York Times
Alka Kudesia needs an expensive drug to treat her breast cancer, but refuses to tell her children for fear they will take out loans to buy the medicine and spend the rest of their lives in debt. “We’re barely able to afford the treatment I’m already getting,” Kudesia (48) said with quiet defiance. “My kids are just starting out in life. There is no way I’m going to be a burden to them.”
The drug, Herceptin, is one of the most effective treatments for an aggressive form of breast cancer. But in India, at a cost of at least €13,000 for one course of treatment, only a small fraction of the women who need it get it. The Indian government last year threatened to allow production of less costly, generic versions of Herceptin. Its maker, Roche Holdings of Switzerland, initially resisted, but surrendered its patent rights this year in large measure because it concluded that it would lose a legal contest in Indian courts.
The skirmishing over Herceptin and other cancer medicines is part of a new and critical phase in a long-running struggle to make drugs affordable to the world’s poorest people, one that began in earnest more than a decade ago when advocates campaigned successfully to make Aids medicines accessible to millions of Africans.
“Cancer is the next HIV/Aids issue, and the fight has only begun,” said Shamnad Basheer, a professor of law at West Bengal National University of Juridical Sciences in Calcutta. US trade officials have voiced concerns about India’s treatment of drug patents, including its reasons for sometimes overriding them. President Barack Obama discussed the issue earlier this year with Prime Minister Manmohan Singh of India during a meeting in the Oval Office, administration officials said.
Executives in the international pharmaceutical industry, increasingly dependent on drug sales in emerging markets such as India, China and Brazil, contend that India’s efforts to cancel patents threaten the global system for discovering cures while doing little to resolve the health challenges most patients here face.
“We are open to discussing what the best way is to bring innovative medicines to patients,” said Daniel Grotzky, a spokesman for Roche, which has a large portfolio of cancer medicines. “But a society that wants to develop new medicines and technology must reward innovation through a solid protection of intellectual property.”
Some health experts say investing in earlier diagnosis of breast cancer and improved testing, surgery and access to radiation therapy is more important than access to expensive drugs. But health advocates say similar arguments were made by the US government and the pharmaceutical industry as they sought to protect patents on Aids medicines through much of the 1990s. It would be unfair to delay improving access to cancer drugs until India’s broken system for cancer care was fixed, they say.