Drugs That Could Be Used to Beat COVID-19 Have Another Barrier – Patents

Patents on potential anti-COVID-19 drugs allow researchers to conduct clinical trials but once they have been approved, the regulations prevent them from being marketed.

On May 14, Reuters reported that the Third World Network, an advocacy group to which the authors of the piece belong, has written to the Indian government asking it to rescind patents given to Gilead Sciences for the drug remdesivir so it can be distributed more fairly to coronavirus patients around the world, particularly in poorer nations. The report quoted one of the authors, K. M. Gopakumar, who illustrated an extension of the point made in this piece – that on profit-making and licences.

Taking into account the relevance of this opinion during the ongoing efforts to make accessible treatment available to all, this piece, originally published on March 29, 2020, is being republished on May 15, 2020.

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In the absence of any vaccines to prevent COVID-19, there are many clinical trials (CT) taking place to find a treatment. These CTs are mainly focusing on either repurposing or repositioning the existing molecules. WHO has published a landscape of therapeutics which could be used for treating COVID-19, and some of them are undergoing CTs as well. Generally speaking, patents are not a concern when it comes to old molecules under CTs because these molecules are already out of patent protection.

However, a few of these molecules are still under patent protection in many countries. Two in particular – Remdesivir and Favipiravir – are under patent protection in India. The generic availability of these medicines can facilitate compassionate use and CTs in India without depending on supply from the patent holders. Therefore, the Government of India should use the compulsory licence or government use license to facilitate the generic production of these medicines.

Some of these medicines are very old molecules, such as chloroquine and hydroxychloroquine, and some are of very recent origin, such as the Lopinavir-Ritonavir combination, which is used to treat HIV/AIDS. Some of these new molecules are still under patent protection in many countries, which are currently using a part of CTs or compassionate use to treat COVID-19. Responding to the patent barriers, a few countries like Israel and Chile have issued compulsory licenses to allow a generic company to produce or use the patented medicine/invention without the permission of the patent holder. Germany even amended its patent law to facilitate the quick issuance of compulsory licenses, while Canada will do so soon. The national assembly of Ecuador passed a resolution empowering the health minister to issue these licenses.

Now, there is one patent granted to Remdesivir, and our search found another application is pending. The recently granted patent will expire only in 2035. Favipiravir is already part of five patents in India, although one of these patents has already expired. However, only a detail analysis can reveal whether existing patents block generic manufacturing.

Remdesivir is believed to be the most promising drug which can be used for treatment against COVID 19. It is a broad-spectrum antiviral drug, which is currently undergoing clinical trials in China. The results are expected towards the end of April. The drug works by inhibiting the virus’s ability to replicate itself inside cells. This indicates that the drug would effective even when a person is in the initial stage of infection and the virus is still reproducing in the upper respiratory tract.

Though it has not shown any efficacy against Ebola, lab and animal studies show have shown that this drug works against SARS and MERS as well, two other respiratory illnesses brought on by coronavirus infections and which are more lethal but less transmissible than the new coronavirus. This medicine is part of the WHO-sponsored multilocational “mega” CT.

Another drug some researchers are putting their hope in is Favipiravir. Favipiravir was developed by the Fujifilm Toyama Chemical corporation, and based on a licensing agreement, the antiviral drug is being manufactured by Zhejiang Hisun Pharmaceuticals for treating influenza viruses. Favipiravir can reportedly treat RNA viruses, like SARS-CoV-2. However, the drug seems less effective in patients with severe symptoms. China has reported using this drug for treating patients in Shenzhen who had tested positive for COVID-19 and found that patients given this drug tested negative four days later. In a trial in Wuhan, the drug has been reported to shorten the duration of patients’ fever from an average of 4.2 days to 2.5 days.

Patents on these chemical compounds have many ramifications for India. Though the Indian Patents Act allows the use of these patented medicines for research and development (R&D) purposes. Further, Section 107 of the Patents Act allows anyone to produce, use and even market the patented medicine without the permission of the patent holder for obtaining regulatory approvals. Thus, Indian generic companies and research institutes are free to produce and use these patented medicines during CTs. But the production use and marketing cannot be done once the regulatory authority provides marketing approval. In reality, these provisions would be of little use because the private sector companies will not make any investment unless there is a guarantee to market in the future.

The other four provisions in the Patents Act would be useful to provide a predictable and long-lasting solution. The first option is the compulsory license provision under Section 84. Under this, a private pharma company can approach the patent office to seek a compulsory license citing any one of  the following three grounds: unmet demands, excessive price and lack of local manufacturing. Any interested person can apply for compulsory licenses from three years from the date of grant of the patent after the failure of efforts to obtain a voluntary license from the patent holder.

As shown in the table (below), the Section 84 option is not available for Remdesivir because the date of the patent grant is in 2020. Any application for a compulsory license before three years from the date of grant is not possible under Section 84. In the case of Favipiravir, a compulsory license application can be made after failure to obtain a voluntary license in a reasonable period.

Though the Patents Act says the “reasonable period shall be construed as a period not ordinarily exceeding six months”, in the current situation, six months is a long period. Further, the issuance of a compulsory license requires hearing of the patent holder and it can delay the issuance of the license. The threat of litigation also make the generic companies to distance from using Section 84 in the case of Favipravir. Therefore, a compulsory license under Section 84 is not an option.

The second option is under Section 92 (3) – in case of a national emergency or circumstances of extreme urgency, public noncommercial use arises during a public health emergency or during a public health crisis, like an epidemic. At this time, the controller of patents has the discretion to grant a compulsory license even without hearing the patent holder. In such circumstances, the applicant does not need to make any attempt to obtain a a voluntary license. The precondition to seek a compulsory license is a government notification saying it is necessary to issue a compulsory license.

The third option is that the government should issue a government issue license on a patent under Section 100. Under this provision, the government directly uses or authorises a private company to make use of the patents.

The fourth option is under Section 102, whereby the government can acquire the patents and allow the generic companies to manufacture the patented molecule.

Only the last three options are looking feasible now – but require government action. The government has a cold foot when it comes to using compulsory licenses, often due to bilateral political pressure from the US. A US-India Business Council submission to the US trade representative in 2016 revealed that Indian officials gave an oral assurance to not to grant any compulsory licenses.

Now, India is in an extraordinary position, and these desperate times demand extraordinary measures, like allowing the generic production of patented medicines. Will the Government of India do what it needs to at this time?

Drug Patent No. Date of filing Date of grant Applicant/Assignee Expiry date
Favipiravir IN226506 August 18, 1999 December 17, 2008 Toyama Chemical Co Ltd August 18, 2019
IN219547 February 14, 2001 May 9, 2008 Toyama Chemical Co Ltd February 14, 2021
IN219369 February 14, 2001 February 5, 2008 Toyama Chemical Co Ltd February 14, 2021
IN261641 February 14, 2001 April 7, 2014 Toyama Chemical Co Ltd February 14, 2021
IN273554 February 14, 2008 June 15, 2016 Toyama Chemical Co Ltd February 14, 2028
Remdesivir IN332280 October 29, 2015 February 18, 2020 GILEAD SCIENCES INC October 29, 2035

K.M. Gopakumar and Prathibha Sivasubramanian are both members of Third World Network.

Note: This article, originally published on March 29, is being republished as K.M. Gopakumar has written to the government asking it to rescind patents given to Gilead Sciences for the drug remdesivir so it can be distributed more fairly to coronavirus patients around the world.

How US Interests Threaten Indian Healthcare

At this crucial juncture, acceptance of US demands on IP enforcement will have a distressing effect on the availability of next generation generic medicines from India

At this crucial juncture, acceptance of US demands on intellectual property enforcement will have a distressing effect on the availability of next generation generic medicines from India.

A patient in South Sudan holding her anti-retroviral drugs. Credit: UNDP/Brian Sokol

The bio-pharma industry’s interests are getting in the way of global health care. Credit: UNDP/Brian Sokol

As Prime Minister Narendra Modi wrapped up his visit to the United States with an address to the US Congress, it should be a matter of concern for people in India that Washington is trying to push its broken intellectual property system on our government – a system of ever-expanding intellectual property (IP) barriers that have caused medicine prices to skyrocket, leaving American patients empty-handed with US insurance companies struggling to manage the cost of reimbursing expensive patented medicines.

These policies, which don’t even domestically work for people in America, should not be forced on people living in India or anywhere else in the world.

Current US IP laws enable pharmaceutical companies to charge exorbitant prices for medicines. For instance, it costs over $100,000 annually for new cancer medicines and $1,000 per pill for the new hepatitis C treatments.

The patent-based innovation system, which is essentially a market and not health-driven model, has also not guaranteed innovation for major diseases. Public health challenges – for example drug development of new antibiotics, antimalarials and research into effective rapid diagnostic kits for TB – are ignored and shelved by the pharmaceutical industry. The billions of dollars of profits from spiraling high drug prices, rather than funding research and development are being diverted to share buybacks and dividends, designed to boost executive pay.

Paradoxically, the US not only insists on turning a blind eye to the ‘access and innovation’ crisis but actually demands new and detrimental IP laws in countries that manufacture and widely use low cost generic medicines to deliver health, worsening an already tragic situation, with millions of people driven into debt with rising out-of-pocket healthcare costs.

Unfortunately, US bio-pharma industry interests are getting in the way of global health care.

India unreservedly produced generic treatments before 2005 when its affiliation with the World Trade Organization necessitated it to start granting patents. This new product patent system first affected cancer patients who are unable to afford expensive, patented cancer medicines costing lakhs per month. In 2012, India issued its first compulsory license (CL), a tool used by governments to override a company’s patent to allow for generic competition. The compulsory license brought down the cost of sorafenib tosylate, a kidney and liver cancer drug, by 97%.

The US government has continuously pressured India to ease the grant of patents to its companies, up the ante on IP enforcement and to put a moratorium on CLs to ensure that US-based multinational pharmaceutical companies enjoy their monopolies without any checks for abuses. Earlier this year, India was once again placed on the US Trade Representative (USTR)’s “Special 301” Report. This coercion has persisted via multiple avenues of bilateral engagement on IP, including the existing US-India Trade Policy Forum and the creation of a new high-level IP working group, which was announced jointly by President Barack Obama and Prime Minister Modi in September 2014.

Modi’s visit comes barely a month after the Indian Patent Office caved in to US pressure and granted US-based pharmaceutical company Gilead Sciences a patent for its hepatitis C drug sofosbuvir – a drug that studies show costs the manufacturer about $100 per 12-week treatment course to make but is sold for $1,000 per pill in the US. The decision comes a little over a year after India initially rejected the patent, which led to increased pressure from the US to grant more patents to its pharmaceutical companies. This step backwards takes away a lifesaving option for patients in many hieric medicines from India.

Indian officials must resist US pressure that undermines its supply of generic drugs, especially during high-level bilateral visits including Modi’s current visit to the US. It must find a strategy to diplomatically reject the IP laws and practices of the US that have led to an unparalleled global health crisis and instead continue to strike a balance between industrial production of generic drugs and the IP system, a policy that has ensured 99% reduction in the cost of medicines to save and improve millions of lives across the world.

Leena Menghaney is Regional Head – South Asia at Médecins Sans Frontières’ Access Campaign. 

Gilead’s Hepatitis C Drug Patent Approved by Indian Patent Office

The Indian Patent Office’s decision marks a setback for patient groups who said the move could stop affordable copies of the Sovaldi drug.

Hepatitis C virus. Credit: Flickr/AJC

Hepatitis C virus. Credit: Flickr/AJC

Delhi: India has reversed course and granted approval to Gilead Sciences Inc’s patent for its hepatitis C drug Sovaldi, marking a setback for patient groups who said the move could stop affordable copies of the drug.

The drug, which has a list price of $1,000 a pill in the US, was rejected for a patent by the Indian patent authority in January 2015 on the basis that it represented only minor changes to a previous formulation and the company already had licensing deals with manufacturers in India.

After an appeal by Gilead, the Indian Patent Office on May 8 approved its application for the drug saying it found its compounds to be “novel” and “inventive”.

Gilead, in a statement, welcomed the move, but said it will have no impact on availability of the compound, which is already licensed to 11 generic manufacturers in India for distribution in 101 developing countries.

Patents guarantee drugmakers exclusive sales for a decade or more, before generic competition is allowed, so the companies can recoup their investment and use profits to then develop new medicines. Gilead said the goal of its voluntary licensing programme and “partnership” with Indian manufacturers is to enable access to medicines for as many people as possible, as quickly as possible.

But patient groups said Gilead’s licensing deals do not serve patients and the patent approval could prevent exports of raw materials to other countries seeking to make the drug, hailed by some as a breakthrough in the global fight against hepatitis.

“Like unmerited patents, these schemes manipulate the market, violate patients’ rights and block millions of people from getting the medicines they need,” the Initiative for Medicines, Access & Knowledge said in a statement.

Gilead said eight of its licensees have launched sales in India and other licensed territories under the company’s programme for supplying its hepatitis C, hepatitis B and HIV drugs to “resource-challenged countries.” Licenses have also been granted to two manufacturers in Egypt and one in Pakistan.

Sovaldi was first launched in the US in 2013 at a list price of $28,000 for a 28-tablet bottle, or $1,000 a pill.

The list price in India as of April 26, according to the Asia Pacific Network of People Living with HIV, was $384 per bottle, or about $14 per pill.

The liver-destroying hepatitis C virus infects as many as 150 million people globally, according to the World Health Organisation.

(Reuters)