The American Medical Student Association (AMSA) is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training. AMSA is also a national member organization of the International Federation of Medical Students’ Associations (IFMSA) comprised of over 1.3 million medical students worldwide. For decades, AMSA has been active in advocating for quality, affordable medicines and mobilizing students to demand real pharmaceutical innovation and oppose strong intellectual property regimes that would prevent our patients and others worldwide from being able to access life-saving medicines.
As the next generation of physician leaders, we are deeply troubled by both the lack of transparency surrounding other free trade agreement negotiations including the current Trans-Pacific Partnership Agreement (TPP) as well as the preferential access to agreement text and negotiators afforded to industry including pharmaceutical, medical device, tobacco, and alcohol companies. While free trade agreements are designed to bolster the economies of the participating member states, they should also benefit the citizenry of those member states. By providing special privileges to negotiating text and parties to these companies and not other civil society organizations, the agreement is in danger of becoming unduly influenced by corporations whose main objective is to make profits often time at the expense of the same citizens to whom these negotiators as government officials are accountable to.
A 2012 updated report from Public Citizen found that since 1991, pharmaceutical manufacturers have reached a total of 239 civil and criminal settlements totaling $30.2 billion with both the federal and state government. These settlements were a result of various illegal behaviors including misleading marketing of brand-name prescription medicines, bribing doctors to prescribe brand-name medications or to manipulate results of clinical trials in the company’s favor, and deliberately overcharging federally-funded health care programs such as Medicare and Medicaid. Allowing these corporations privileged access to the negotiating text is clearly a conflict of interest serving to not create a trade agreement that will benefit the member state populations, but instead will only cater to the companies goal to garner maximum profit. AMSA strongly believes that the trade agreement negotiations must be open and accountable to all. It is essential that the full TTIP text be subject to public scrutiny and reflect the priorities of the global citizenry. We echo the call by various civil society organizations for the United States and European Union to publicly release all negotiating and pre-negotiating texts on an ongoing basis.
As physicians-in-training, we believe that trade agreements should promote public health and access to medicines rather than prioritizing multinational corporate profits over patients. For this reason, we first and foremost urge the exclusion of any and all intellectual property provisions in the TTIP.
During our medical training, we witness firsthand the crucial benefit that access to affordable medicines gives to patients. The ability to receive such life-saving drugs is critical in preventing unnecessary deaths due to both infectious and non-communicable diseases. Unfortunately, it appears that recent free trade agreements (FTAs) including the Australia-United States FTA and Korea-United States FTA as well as the current TPP negotiations compromise this access by imposing unprecedented TRIPS-plus IP provisions. These provisions have the potential to jeopardize millions of lives in participating countries by granting monopoly protections to pharmaceutical companies, driving up the costs of medicines significantly. It is unacceptable that cost as a result of this agreement will become a barrier to access and ultimately, a healthy life.
If included in the agreement, these provisions have the potential to jeopardize millions of lives in TPP participating countries by driving up the costs of medicines significantly. Even in the United States, there has been an outcry from the physician community regarding the high cost of medicines. Just in the past month, over 100 oncologists came together to write a perspective piece in Blood journal calling the prices of brand-name cancer drugs “astronomical, unsustainable, and perhaps even immoral.” The United States health care system has in fact greatly benefitted from the entry of generic competition. On May 9, IMS Health released a report entitled Declining Medicine Use and Costs: For Better or Worse?, which found that the per capita spending on pharmaceuticals decreased in 2012 as compared to the previous year by $33 and that patent expiries in 2012 contributed to $28.9 billion to the reduction of drug spending with patients being able to access more generic versions of medicines. The report also found that many American patients in their struggle to afford health care had given up much needed doctor visits, medicines, and other treatments. In light of this, AMSA urges the USTR to not table strong intellectual property provisions in the TTIP that will increase the cost burden of healthcare for patients both at home and abroad.
To ensure the TTIP does not compromise access to medicines for our patients and those in participating countries, we urge the following:
- Prohibition of “evergreening” or use of minor modifications of existing drugs to extend market exclusivity;
- Exemption from patent infringement of diagnostic, therapeutic, and surgical