The pharmaceutical industry is denying medicines to millions of poor people and undermining its own future because it refuse to change the way it does business in developing country markets.

This is according to an Oxfam report, ‘€˜Investing for Life’€™, that examines the world’€™s top 12 pharmaceutical companies, including their drug pricing policies, record in developing medicines relevant to poorer countries and their stance on protecting intellectual property rights.

The report claims that the industry is failing to ensure universal access to medicines because it refused to put the issue at the heart of its business model.

As a result, it is failing to capture the full potential of emerging markets touted as the ‘€œnew frontier’€ for its business success.

‘€œThe industry is burying its head in the sand. More than 85 percent of world consumers are underserved or have no access to its medicines. The industry must recognise that charging high prices, quashing generic competition, developing medicines only for those rich enough to pay and fighting for harsher patent laws is an ineffective business strategy for new markets, as much as it is a moral outrage,’€ said Jeremy Hobbs, Oxfam International executive director.

‘€œInvestors are worried about the industry’€™s performance. They know that emerging markets are key for the industry’€™s future growth but companies have been responding to the challenge of breaking into emerging markets in an ad-hoc and inconsistent way.

‘€œThis is bad for the industry and bad for poor people who are still facing devastating diseases like malaria, tuberculosis, asthma, cancer, and HIV/AIDS without affordable medicines,’€ Hobbs said.

The report revealed shortcomings where the industry:

• Has failed to implement a systematic and transparent tiered-pricing policy, where prices for all essential medicines are set according to people’€™s ability to pay;
• Continues largely to neglect research and development into diseases that predominantly affect poor people in developing countries;
• Continues to be inflexible in protecting intellectual property, including challenging poor countries in court to stop them using legal public health safeguards;
• Continues to rely too heavily on donations to get affordable medicines to people, even though this is unsustainable and sometimes counter-productive.

Oxfam said that some companies were offering differentiated prices but this was extremely limited and mainly for high-profile diseases such as HIV and AIDS.

However, these offers were not systematic worldwide and were often still priced well above the means of people living in developing countries.

Oxfam said that drug companies often adapted pricing in developing countries solely as a reflection of the publicity that surrounds the disease or the country.

For instance, Abbott Laboratories was selling Kaletra ‘€“ a second line anti-retroviral medicine ‘€“ at u$2 200 (R15 400) per patient per year in low middle-income countries like Guatemala, where a person’€™s average wage is U$2 400 (R16 800) a year.  

Only until Thailand, in response to the needs of poor HIV patients, issued a compulsory license to reduce the price of Kaletra to U$1 000 (R7 000), did Abbott reduce the price of Kaletra worldwide to U$1,000 per patient per year.

Also in Thailand, French giant Sanofi-Aventis offered its cardiovascular disease medicine Plavix at a price that was 60 times more expensive than Emcure, the Indian generic version.

In March 2007, it responded to Thailand’€™s use of compulsory licensing by offering a 70 percent cut.

Oxfam’€™s report said that companies were still not investing enough into researching and developing medicines for diseases that predominantly affected poor people in developing countries.

Between 1999 and 2004, there were only three new innovative drugs targeted at diseases affecting the developing world out of 163 medicines brought to the market.

‘€œEven people suffering from tuberculosis ‘€“ which kills nearly two million people a year ‘€“ need six months of treatment and the most recent medicine is 30 years old,’€ said Helena Vines-Fiestas, author of the report.

On the industry’€™s approach to intellectual property rights, Vines-Fiestas said: ‘€œHigh levels of intellectual property protection have not resulted in new cures for diseases that affect poor people.’€

Despite this, the report noted that the industry continued to insist that the global intellectual property regime did not prevent poor people from accessing affordable medicines.

Oxfam said not only was the industry’€™s view narrow-minded and wrong, but that the evidence was overwhelming that generic competition was the most effective and proven method to reduce drug prices.

In recent years companies have mounted legal challenges or exerted direct pressure to protect their patents against the legitimate use of safeguards in Thailand, Brazil and India. ‘€œThese challenges are made at the direct expense of poor people,’€ Oxfam said.

‘€œThe industry is failing to make the systematic changes needed to serve developing country markets and meet its responsibility to make medicines universally available. Public pressure will intensify if companies continue to offer only patchy concessions, for example around high profile diseases such as HIV/AIDS and malaria,’€ said Vines-Fiestas.

The report argued that companies would need to revamp their approaches on pricing structures, R&D investment and patent policies in order to serve these markets and make its medicines more accessible to poor people.

Companies should adapt to the realities of developing country markets because up to 80 per cent of people in developing countries are vulnerable to falling or staying below the poverty line if they have to bear the cost of expensive medicines, particularly where treatment is long-term.

‘€œThe industry is operating in a short-sighted way because it could gain enormous benefits from emerging markets, including lower research and development costs and cheaper manufacturing. Yet instead it continues to blindly use its same strategies in poor countries.   Even today, the richest 15 percent of the world consumes over 90 percent of its pharmaceuticals. At this rate, both the industry and millions of sick patients are losing out,’€ said Hobbs.

The 12 companies analyzed and interviewed for the purpose of the report were Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly, Johnson & Johnson, Merck, Novartis, Pfizer, Roche, Sanofi-Aventis and Wyeth.

The full report can be found at http://www.oxfam.org/en/policy/briefingpapers/bp109_investing_for_life_0711