As Modi Visits US, What Does the Free Trade Pact Mean for India’s Pharma Industry?

A Free Trade Agreement with the US will likely result in the amendment of the Patents Act, which could impact the Indian pharma industry. 

Prime Minister Narendra Modi is scheduled to travel to the US on Saturday to attend the annual United Nations General Assembly in New York and will address the high-level general assembly session on September 27. The Indian prime minister is also expected to have several high-level bilateral and multilateral engagements on the sidelines of the UN meeting. Among all his engagements, the one with US President Donald Trump is the most keenly-awaited.

President Trump will be joining Prime Minister Modi in Houston on September 22 for the “Howdy Modi” event, when the latter will be addressing the Indian community. The statement from the White House press secretary says that it will be a great opportunity for the two leaders to “discuss ways to deepen their energy and trade relationship”. The proposed Free Trade Agreement (FTA) between the two countries is expected to be high on the agenda.

Implications of the FTA

What are the implications of an FTA between the two countries for India? Concerns of the US on policies and practices of India in trade issues, highlighted in the ‘National Trade Estimate Reports on Foreign Trade Barriers’ and on the protection and enforcement of intellectual property rights (IPRs), highlighted in the ‘Special 301 Reports’ give an indication of the issues that the US would want to address in the FTA. 

The Special 301 Reports have been raising matters with regard to the Patents Act of India, such as narrow patentability standards – which puts a check on pharmaceutical innovations that do not show therapeutic efficacy – and lack of protection of test data submitted to regulatory authorities (data exclusivity). Resolution of these issues to the satisfaction of the US could lead to the amendment of the Patents Act, but that could impact the Indian pharma industry. 

The Bipartisan Congressional Trade Priorities and Accountability Act of 2015 (TPA 2015) of the US sets clear objectives for its administration and FTA negotiating partners on the expectation of the Congress. In the US, unlike India, the approval of Congress is mandatory for the ratification of trade agreements. TPA 2015 requires the US administration to ensure that trade agreements covering IPRs should “reflect a standard of protection similar to that found in United States law”. 

Impact on pharma industry

The IPR chapter of the re-negotiated NAFTA agreement (NAFTA 2.0), on the lines of TPA 2015, reflects the standard of patent protection in the US, which the administration would seek its FTA partners to have in place. 

There are three key provisions in the IPR chapter of NAFTA 2.0, which if incorporated into the Patents Act, would severely hit the Indian pharma industry. 

One, it provides for patents for all innovations, which includes new uses of a known product, new methods of using a known product or new processes of using a known product. But section 3(d) of India’s Patents Act allows innovations of this nature, in pharmaceutical products, only if the innovations prove therapeutic efficacy.

Section 3(d) not only checks the ‘evergreening’ of patents and frivolous patents, thereby providing more space for generic manufacturers, but also contributes in ensuring the quality of innovations by filtering in only meritorious innovations. An FTA with the US could lead to the removal of this section from the Indian Patents Act; in fact, the US has been making this demand for a long time. 

Also read: How Consultative Has India’s RCEP Strategy Really Been?

A study commissioned by the Shuttleworth Foundation finds that nearly half of rejection of patent applications, in pharmaceutical innovations, by Indian Patent Office is on account of the application of Section 3(d). This shows the crucial role played by this clause in checking ‘evergreening’ of patents in India, thereby ensuring more space for producers of generic medicines. Inspired by this clause of the Indian Patents Act, countries like the Philippines, South Africa, Brazil, etc. have amended their patent laws. 

Two, the intellectual property chapter of NAFTA 2.0 provides for data exclusivity for a minimum of five years for new pharmaceutical products, ten years for biologics and an additional three years for new clinical information – new indication, new formulation or new method of administration, etc.

This is additional protection apart from the patent protection, starting from the application for market approval. This can effectively lengthen the exclusivity period beyond the patent term, when the regulatory approval process is initiated towards the end of the patent period.

Currently, India does not provide for data exclusivity. Introduction of this provision into the Patents Act or the procedure for approval of generic medicines would result in a delay in the introduction of generic drugs. 

Approval of generic drugs now is done based on the production of evidence for bioequivalence of the generic drug to that of the originator drug. Introduction of data exclusivity will mean that the generic manufacturers either wait for the data exclusivity period to be over or repeat the entire clinical trials for the generation of safety and efficacy data again, if they have to apply for marketing approval. All of this delays the entry of generic drugs into the market and will impact the health of millions around the world, and not just in India. 

Also read: Why India’s Pharma Industry Needs to Act Now to Win Back the Trust It Lost

Three, the intellectual property chapter of NAFTA 2.0 requires linking of marketing approval of generic drugs to the patent status of that drug (patent linkage). Parties to NAFTA 2.0 are required to notify the patent holder, the one who submitted the safety and efficacy data when companies apply for marketing approval of generic versions of the same drug.

This considerably enhances the monopoly power of the patent holder. Now the market approval system of India, which functions under the Drugs and Cosmetics Act, is not linked to the patent system of India. If there is an infringement of the rights of the patent holder, he/she can initiate proceedings against the manufacturer after the generic drug is launched in the market. Introduction of patent linkage will strengthen the position of patent holder vis-a-vis generic manufacturers and the latter may find it too risky to invest in the production of generic drugs. 

All these three aspects go beyond the requirement of the WTO TRIPS Agreement. An FTA with the US, in all likelihood, will result in the amendment of the Patents Act. India enacted a well-crafted and TRIPS compliant Patent Act in 2005 (Patents Amendment Act 2005), utilising the flexibilities provided in the TRIPS Agreement, aimed at protecting the Indian pharma industry and facilitating affordable access of medicines. 

It should be noted in this context that the National Health Policy 2017 explicitly recognised that incidents of catastrophic expenses on healthcare are a major reason for families falling into poverty. Expenditure on medicines is the single-largest component of healthcare expenditure in India. 

So amendments to the Patents Act at the insistence of the US will pave the way for ‘evergreening’ of pharmaceutical patents in India, thereby curtailing competition in the market. The pharmaceutical industry is one of the few in which India has a price advantage globally, which has earned it the ‘pharmacy of the world’ tag. An FTA with the US will severely shake the foundation stones on which the Indian pharma industry has been built upon. 

Reji K. Joseph is an associate professor at the Institute for Studies in Industrial Development, New Delhi. Views are personal.

Compulsory Licenses Needed in India to Ensure Affordable Medicines

NSS data reveals that a majority of rural and urban populations did not get proper medical treatment because of the expense.

NSS data reveals that a majority of rural and urban populations don’t get proper medical treatment because of the expense.

Credit: Jamie/Flickr CC BY 2.0

Credit: Jamie/Flickr CC BY 2.0

The latest decennial National Sample Survey (NSS) report on morbidity and health, released recently by the Ministry of Statistics and Programme Implementation, provides important leads for why India should more proactively make medicines more affordable. This includes resorting to measures including compulsory licenses to reduce the cost of medicines. It shows that medicines account for much of people’s spending on health care. In outpatient care (non-hospitalisation) where more than four-fifth of reported cases of ailments got treated in urban and rural areas, expenditure on medicines (only allopathic medicines) account for 68% in rural areas and 64% in urban areas of total medical expenditure. This shows how critical medicines are to our healthcare system as compared to advanced countries, where cost of medicines in healthcare expenditure is much less significant.

What would people do when they are ill, if they do not have the capacity to pay for medicines? They will not get proper treatment and resort to alternatives such as home remedies whenever possible. Four percent of the sick in rural areas and 2.5% in urban areas took no care at all, analysis in Sundararaman and Muraleedharan’s  article on NSS data shows. Of those who resorted to alternatives such as self-medication, this NSS report shows that 57% in rural areas and 68% in urban areas did not turn to professional medical treatment due to financial constrains. This is very different from other factors such as ailment not considered serious or lack of healthcare facilities in the neighbourhood. If a large number of people are opting out of proper treatment due to financial reasons, the cost of medicines is the most significant contributing factor.

Cancer provides the best example of cost of medicines preventing people from getting treatment. There are a number of new patented cancer drugs whose prices are very high. Out of an estimated 1.1 million cancer patients in India, only 36% are receiving treatment, statistics presented by V. Shanta of the Adyar Cancer Institute show. The NSS report also shows that cancer involves the highest expenditure for treatment among all diseases. The medical expenditure for cancer was more than six times the average medical expenditure (for all diseases) in urban areas and more than double in rural areas.

Compulsory licenses

These observations assume greater significance in the light of the discussions in India on issuing compulsory licenses. The patent law in India allows granting of compulsory license to produce and sell cheaper versions of drugs under certain circumstances, including if drugs are priced so high that they are not affordable to patients. India has so far granted only one compulsory license. Applications by BDR Pharma on a cancer drug and Lee Pharma on a type II diabetes drug were rejected for various reasons.

The Pharmaceutical Research and Manufacturers of America and US-India Business Council, in their inputs to United States Trade Representative for the Special 301 Report 2016, submitted that India had privately assured US business that Indian patent office would adopt a stringent approach in granting compulsory licenses. The government of India refuted this allegation through a press release. The National Human Rights Commission of India, however, issued a press release in April this year expressing concerns on the media reports over the private assurance given by the government and the denial of the two applications for compulsory licenses, emphasising the responsibility of the government to provide affordable healthcare to its citizens.

Lee Pharma’s application was rejected in January this year as it was not able to satisfy the Patent Office of India that the reasonable requirements of the public were not met by the patented medicine. The Patent Office wanted Lee Pharma to provide data, among other things, on the number of people affected by Type II Diabetes, alternate drugs available and their market share to see if the requirement of the public was actually met with. But the fact is that this data is not available in the public domain. The market share data which the National Pharmaceutical Pricing Authority relies on for regulating drug prices is not shared with the public. It is not fair of the Patent Office to insist on data which is not publicly available, thereby denying more patients the opportunity to access healthcare services. Rather, evidence coming out of this NSS report should be used by the stakeholders to understand the significance of cost of medicines in India’s healthcare system.

Reji K. Joseph is Associate Professor at Institute for Studies in Industrial Development (ISID), New Delhi.