Picture this: a patient returns to the office for a follow-up visit with their physician. When asked how the prescribed treatment is working out, they answer: “I don’t know, I couldn’t afford to fill the prescription.”
It’s a story to which a growing number of Canadians, and nearly every Canadian doctor, can relate.
Canadians value our medicare system, a system that allows us to see doctors without paying up-front costs. Unfortunately, according to a recent Angus Reid survey, 23% of Canadians are unable to take their drugs as prescribed and this leads to worse health, missed work, unnecessary hospitalizations, and even death.
According to leaked drafts of the secretly negotiated Trans Pacific Partnership (TPP), the deal could increase the price of prescription drugs putting life saving drugs out of reach of even more Canadians.
The proposed intellectual property rules will excessively boost patent and data protections for brand name drug companies while preventing price-lowering generic competition. Based on this information, it appears the TPP will undermine the ability of governments to bulk purchase drugs, thus preventing governments from negotiating better drug prices from large pharmaceutical companies.
Through the TPP, drug companies intend to protect their absurd profit margins. Lipitor for example, a popular cholesterol-lowering drug, costs $800 per year for a Canadian but only $15 per year in New Zealand where bulk purchases and price negotiations have dramatically lowered the price.
Why did the Harper government agree to force cash-strapped Canadians to fork out for brand name drugs? Perhaps it is because the drug companies, through organizations like the Pharmaceutical Research and Manufactures of America (PhRMA), have spent over $110 million lobbying the US Congress to support the TPP.
Prolonging patents through "data exclusivity windows" via the TPP would keep an increasingly important category of drugs, known as biologic agents, out of the hands of the patients. Biologic agents include vaccines, blood products and gene therapies - agents that are often the only available treatment for certain diseases. Canada currently allows an eight-year exclusivity window, whereas Australia has a 5-year window and got to keep it in the TPP.
In signing the TPP, Canada would forego the opportunity to decrease the window period future while keeping generics off the shelf for excessive periods of time.
During the lead-up to this federal election, three out of the four main parties have called for some way to control drug costs, ranging from bulk buying to universal drug coverage or pharmacare. Pharmacare would be the biggest step forward in Canadian healthcare since the introduction of Medicare. In fact, Canada is the only OECD country with universal health care that doesn’t include drug coverage.
The growing call for universal drug coverage stems from the realization that Canadians should be able to take medications as prescribed, regardless of their financial situation. Recent studies suggest that a national Pharmacare program would save Canadians $6 to 7 billion per year. This sound economic plan would be impossible with TPP limits on bulk purchasing and generic drugs.
Looking beyond Canada, groups such as Médecins Sans Frontières (MSF) have called for the provisions for patent protection to be removed from the TPP. MSF Canada has called the TPP “the most harmful trade pact ever for access to medications”. Drugs for diseases such as HIV and TB have become more affordable because generic competition has brought the cost of treatment down. It was through generic competition that first generation antiretrovirals decreased in cost by 99% in just ten years.
Without lifesaving generic medication, diseases will continue to spread and millions of people in middle- and low-income countries will suffer. Will it take these public health emergencies reaching Canada to realize how truly short-sighted this trade agreement is?
When asked, Canadians invariably name health and health care as their highest priorities. They deserve to know when these are in jeopardy, and that includes knowing the full details of international trade and investment agreements.
The TPP appears to pose risks to our ability to afford and provide needed medications to Canadians, and others around the world. It should be exposed as such. Public policy should be made with the health of Canadians in mind: any deal that makes us unable to do so is a deal we shouldn’t sign.
Sarah Giles is a family doctor practicing in the Northwest Territories. She is a board member of Canadian Doctors for Medicare and an Assistant Clinical Professor at the University of Alberta. Broadbent Fellow Dr. Ryan Meili is a family physician, Assistant Professor in the Department of Community Health and Epidemiology at the University of Saskatchewan and founder of Upstream.
Photo: Global Trade Watch. Used under a BY-ND-2.0 license