Friday, February 23, 2007

The owner of the Against Monopoly site (see also our links section) has posted an interesting item on the relative costs of the monopoly granted by drug patents. It is basically a report on a case study published in the American Economic Review of the relative costs and benefits of patent protection in the case of quinolone antibiotics. The generally accepted opinion is that the loss to a developing country is about 150% of the gain to the developed country holding the patent. This, according to the study cited, is a gross underestimate as the conventional wisdom counts the cost to the pharmaceutical industry in a developing country but ignores the cost to consumers in such a country. In the case studied, quinolone antibiotics in India, domestic Indian firms may actually gain as consumers opt for other less expensive domestically produced drugs not covered by patent protection. The Indian government regulates the price of imported drugs, and the loss to the Indian consumer depends upon the letter of the price regulation by their government. According to the study the net loss (read transfer of money from India to countries/companies holding the patents) can range from $144 to $450 million dollars. The gain to the multinationals ranges from $19.6 to $53 million dollars. In other words the loss to the Indian consumer of these drugs is 7 to 9 times the gain of of the foreign companies.
Go on over to the Against Monopoly site for the full article.
Molly Note:
The whole subject of quinolone antibiotics is covered very extensively in the CPS and on the net in a less extensive treatment at the American Family Physician site. For the totally uninitiated the fluoroquinolones are derivatives of nalidixic acid- the old "drink more cranberry juice for your bladder infection" standby. This classification of antibiotics acts by inhibiting "topoisomerase" enzymes in bacteria. There are four classes of this enzyme, one of which, "type II", is the "DNA gyrase" that Molly was under the impression that all quinolone antibiotics acted on. In actual fact the various drugs may also act on the "type IV" topoisomerase, action which is associated with increased activity against gram positive bacteria. in human medicine the "second generation" quinolones such as ciprofloxacin have now passed beyond patent protection, and there are now 3rd and 4th generation quinolones that claim better pharmaceutical properties and efficacy. There are actually a whole slew of these drugs whose claims to patents depend upon minor tweaking of the molecular structure. For the average practitioner, both human and veterinary evaluating the various claims can be an exercise in "head banging". In the veterinary field the old standby is enrofloxacin (Baytril). Orbifloxacin (Orbax) nad marbofloxacin (Zeniquin) are also available (at an increased price of course, because they have patent protection). Claims by the companies holding the patent rights to the newer drugs are usually countered by propaganda from the original drug company. Like most veterinarians I depend upon academic reviewers for an unbiased comparison, but I have yet to come upon such, and so I stick with the old Baytril.
In the human field the situation is even more confused, and I pity the doctors trying to make a rational choice amongst the alternatives. Ciprofloxacin, by the way, is now available in Canada at least in generic formulation from both Apotex and Novo-Pharm. Some pharmacies make an automatic policy of generic substitution and some don't. Best to query both your doctor and your pharmacist directly.

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