US trade deal: drug prices are still at risk
By patient leaders Simon Brasch and Anne Maclean Chang.
We are two patients who have been lucky enough to access the treatment we needed on the NHS. One of us (Simon) is a hepatitis C patient and the other (Anne) a breast cancer patient. Two very different illnesses, with one common problem - the companies who sell the drugs we need exploited their monopolies to charge unaffordable prices, preventing access for patients like us.
High drug prices affect patients in very real and sometimes life threatening ways. Simon had to wait nearly a year to access new hep C drugs - they were so expensive that they were rationed on the NHS. Anne was able to access the breast cancer drug Kadcyla only after a public campaign led to the drug company Roche agreeing to lower the price.
We are at the receiving end of a drug development system that places pharmaceutical company wealth over public health and the needs of ordinary people. The NHS has a number of safeguards which prevent the situation becoming even worse than it already is. But in the US - which has the highest drug prices in the world - they don’t have many of the same protections, with a system staked even more in favour of big pharma. And under a US trade deal, there is a very real risk that Donald Trump and the pharmaceutical industry will try to export their deadly, dysfunctional system to the UK.
“there is a very real risk that Donald Trump and the pharmaceutical industry will try to export their deadly, dysfunctional system to the UK”
The government has insisted that the NHS and drug pricing will not be on the table in trade negotiations with the US. But they said that before about food standards and there are already signs they may not keep that promise.
And it is not entirely in their power to keep this topic off the table. The US government has for years worked hand in hand with the hugely powerful pharma lobby to use trade talks like these to strengthen their monopoly powers across the world. They’ve created a long list of changes they want to see the US win in talks with the UK.
Trump, facing growing anger at high medicine prices in the US, has said he’s going to cut prices in the States by forcing other countries to pay more. US negotiators are likely to demand changes in how we grant drug companies monopolies, the watering down of the powers of regulatory bodies like NICE (the National Institute for Health and Care Excellence), and weakening of NHS negotiating powers.
If they are successful prices will go up, leading directly to the problems patients like us have witnessed first hand - a lack of availability of life-extending and life-saving drugs on our NHS.
“In trade negotiations the devil is in the detail”
In trade negotiations the devil is in the detail, and catch-all statements like the ”NHS is not for sale” or “drug pricing will not be on the table” can often mask technical language which doesn’t appear to be dangerous yet could in fact tilt the balance of power in negotiations away from the NHS and towards the profiteers in pharma.
The UK’s newly published negotiating mandate says that the government will:
“Secure patents, trade marks, and designs provisions that:
protect the UK’s existing intellectual property [IP] standards and seek an effective and balanced regime which encourages and supports innovation [...]
do not lead to increased medicines prices for the NHS”
“There is no mention of the UK’s approach to non-patent exclusivities ”
The government has said they won’t allow medicines prices to increase. At the same time they are leaving the door open to changes in the intellectual property [IP] system under the banner of “encourag[ing] and support[ing] innovation”. There is no mention of the UK’s approach to non-patent exclusivities in the document, and no guarantees that NICE would be protected.
“If the government seriously wanted to exclude the NHS and drug pricing from negotiations, there are simple ways it could do this”
We have seen time and again that drug companies exploit patent and non patent monopolies to charge extortionate prices - even for medicines that are developed with high levels of public funding.
Proper transparency and scrutiny of the negotiation text is going to be essential if we are able to hold the government to account on their commitments to protect the NHS. If the government seriously wanted to exclude the NHS and drug pricing from negotiations, there are simple ways it could do this. They could make it illegal for trade deals with other countries to raise NHS drug prices; they could exclude any conditions in new trade agreements that undermine the role of the regulator NICE, extend patents or non patent exclusivities. Creating a ‘positive list’ would allow them to specify exactly what would be part of a trade deal - and therefore what wouldn’t. Until safeguards such as these are put in place then everything remains on the table.