[Ip-health] UACT Letter to NAFTA Negotiators

Manon Ress manon.ress at keionline.org
Fri Dec 8 11:54:27 PST 2017


On December 8, 2017, UACT submitted a letter to the US, Canadian, and
Mexican representatives of the NAFTA re-negotiations. Please find below the
full text of the letter. A PDF version is available here.
https://cancerunion.org/2017/12/08/uact-letter-to-nafta-negotiators/

Union for Affordable Cancer Treatment
1621 Connecticut Avenue NW
Suite 500
Washington, DC 20009
Tel.: 202.332.2670
www.uact.org

December 8, 2017

Dear NAFTA Delegates,

The Union for Affordable Cancer Treatment (UACT), created in 2014, is a
union of people affected by cancer, their family members and friends,
people who take care of people with cancer, health care professionals and
cancer researchers committed to increasing access to effective cancer
treatment and care. We are particularly concerned about the rapidly
escalating cost of cancer medication.

We are writing to ask you to ensure that the renegotiations of NAFTA do not
result in higher prices for cancer patients and payers such as governments
or private payers. If pharmaceutical industries are given stronger monopoly
protections for pharmaceutical drugs, vaccines or medical devices, it will
make it even more difficult –if not impossible– to address pricing abuses
in the United States.

High prices of drugs for diseases, including cancer, are among the most
pressing health and budget issues we are all facing. Prices of the newest
drugs for cancer are extremely expensive. For example, Alunbrig, a
second-line treatment for ALK-positive, non-small cell lung cancer, was
introduced this year by Takeda at an annual cost of $170,000, a price far
above what is reasonable or sustainable and which blocks access for
patients. Another example is the drug keeping me alive today, Kadcyla,
which costs around $9,800 per month or about $94,000 for an average
treatment. It is the best drug today to treat HER2-positive breast cancer
which has spread to other parts of the body, cannot be surgically removed
and has stopped responding to initial treatment.

UACT is urging you, the NAFTA negotiators, to protect the ability of
governments and courts to permit third parties to use patents without the
permission of right holders, when there are pricing abuses.

UACT recognizes that the rationale for granting time limited monopolies on
new drugs, vaccines and other medical technologies such as diagnostic tests
and CAR-T treatments is to stimulate investments in research and
development (R&D) for new products. However, it is our opinion that it is a
historic and harmful mistake to link the incentives for R&D to the prices
of new products. By linking incentives to the prices of products,
policymakers have set up a no-win conflict between access and innovation,
and also embraced a very expensive, wasteful and unfair mechanism to
finance R&D.

UACT proposes that the NAFTA members agree to create a new model for
dealing with medical innovation that delinks R&D funding, including
incentives, from product prices. In the delinkage approach, governments
cooperate in funding medical innovation as a public good, through a
combination of enhanced and equitable funding of research through grants,
research contracts, subsidies (such as the Orphan Drug Tax Credit subsidy
for trials, which could be expanded in a delinkage model) and reformed
incentives (based upon cash rewards, rather than the grant of legal
monopolies).

One initial step towards a new paradigm for trade agreements would be to
include a chapter on the supply of public goods, to ensure robust funding
for open biomedical research.

NAFTA members could also agree to certain minimum standards for funding and
to subsidizing R&D through flexible mechanisms.

As noted above, the grant of a patent monopoly is only one way to fund and
reward medical innovation. The grant of a legal monopoly is associated with
large costs imposed on society in general and patients in particular. It is
important to allow governments to innovate in the business models they use
to stimulate innovation. The revised NAFTA should not lock-in flawed and
harmful business models that are no longer working well, and which pit
innovation against affordability and access, and which one government
official noted, has created a situation where drug companies “are getting
away with murder.”

In return for taking these measures to enhance the resources for medical
R&D, NAFTA members should have the maximum flexibility to eliminate or
limit monopolies on unreasonably priced or unavailable medical products and
technologies.

Finally, a chapter in NAFTA could address a range of issues relating to
transparency, including joint agreements to require sufficiently detailed
disclosure of R&D costs, revenues and prices for products, and public
access to appropriate details for the scientific data from clinical trials
and reporting of adverse effects of treatments, and the outlays on
marketing products.

Sincerely,

Manon Ress
Acting Director, Union for Affordable Cancer Treatment (UACT)
http://uact.org/

2017-12-08


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