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Discussions of Intellectual Property and Health Care "To see the collection of prior postings to the list, visit the Ip-health Archives." This is one of the very best places to learn about the battle -access to medicines vs drug patents and the drug cartel. If you saw the film "Fire in the Blood" you saw how, in this era of global epidemics and corporate greed people must stand up for the rights of human beings to lifesaving drugs at affordable and not extortionate prices. This URL brings one straight to the list archives.

'Ticking Time Bomb': Corporate Lawyers Openly Discussing Suing Nations Over Profits Lost to Covid-19 Measures

By Jake Johnson, Common Dreams. This is a major issue, Like Slovakia with its health insurance mess, in Achmea, once countries sign trade deals, they can't enact regulations that they need for common sense reasons, ISDS makes it impossible for countries to do things like close for epidemics, or limit business operations in needed ways, or (if they apply to foreign companies and their workers) It may even make it FTA illegal to raise minimum wages. Imagine if you could not fix deep seated problems like environmental risks, lack of affordable healthcare or rising education prices. That would be the US today. Thanks to ISDS and ISDS-like provisions in the WTO, now, for 20 years, corporations have always come first. This is why people can't be allowed to vote for improvements.

Health Policy Watch: World Health Assembly Prepares For Show Of Unity On Global COVID-19 Response – But Potential Dispute Over Taiwan

Analysis 15/05/2020 • Elaine Ruth Fletcher The world seems set to make at least a symbolic display of unity in the battle against the COVID-19 pandemic at the upcoming World Health Assembly (WHA), which begins on Monday. The WHO’s 194 member states are expected to overwhelmingly approve a European Union-led Resolution that aims to step up the global COVID-19 response, and ensure equitable access to treatments and future vaccines. But the show is unlikely to go off as smoothly as some might hope, and not only because the 73rd Assembly is meeting for the first time ever in a virtual format.

Lowered insulin price should be made permanent

the Lilly company has temporarily lowered the price of insulin to $35/month. As anybody who reads the paper knows, LOTS of Americans, both young and old, are dying because they cannot afford insulin's insane price.

Our right to regulate drug prices was signed away when we joined the WTO.

The TRIPS agreement is part of the WTO. It was meant to jack up the prices of drugs all around the world. GATS (another WTO agreement) gave countries another bargaining chip they could use, jobs. . A logical approach would be for us to dump both GATS and TRIPS at the same time. That would give the poor countries (And US) back our right to regulate prices and get affordable drugs, we could keep the potentially millions of jobs that could end up being traded away in GATS. We would also get back our right to have affordable healthcare, and prevent Medicare and Social Security from being privatized.

Foreign Free Riders and the High Price of US Medicines

We can find no evidence to support the widely believed claims from industry that lower prices in other industrialised countries do not allow companies to recover their R&D costs; so they have to charge Americans more to make up the difference and pay for these "foreign free riders." We also explain why the claims themselves contradict the economic nature of the pharmaceutical industry. The latest report from the UK Pharmaceutical Price Regulation Scheme shows that drug companies in the United Kingdom invest more of their revenues from domestic sales in research and development than do companies in the US. Prices in the UK are much lower than those in the US yet profits remain robust. Companies in other countries also manage to recover their research and development costs, maintain high profits, and sell drugs at substantially lower prices than in the US. For example, in Canada the 35 companies that are members of the brand name industry association report that income from domestic sales is, on average, about 10 times greater than research and development costs. They have profits higher than makers of computer equipment and telecommunications carriers despite prices being about 40% lower than in the US.

Drug Companies Will Make a Killing From Coronavirus Unless we fix the system, American taxpayers will get gouged on a vaccine they paid to produce.

Opinion Drug Companies Will Make a Killing From Coronavirus Unless we fix the system, American taxpayers will get gouged on a vaccine they paid to produce. By Mariana Mazzucato and Azzi Momenghalibaf Ms. Mazzucato is a professor at University College London and the author of “The Value of Everything.” Ms. Momenghalibaf is a senior program officer at the Open Society Public Health Program. https://www.nytimes.com/2020/03/18/opinion/coronavirus-vaccine-cost.html

Gilead Outrageously Seeks Super-Monopoly Protections for Covid-19 Drug remdesivir

Statement of Peter Maybarduk, Director, Public Citizen’s Access to Medicines Program Note: The U.S. Food and Drug Administration today granted experimental COVID-19 treatment remdesivir a special orphan status intended for drugs that treat rare diseases. The status sets up remdesivir’s manufacturer Gilead Sciences to receive additional federal tax credits in the United States and a bonus lucrative seven-year market exclusivity, allowing Gilead to exclude generic and more affordable competition while charging high monopoly prices, if the drug is approved. Gilead’s pursuit of an orphan designation is unconscionable and could be deeply harmful. Remdesivir is one of relatively few medicines that may prove effective in treating COVID-19 this year. The government should be urgently concerned with its affordability for citizens. Instead, the FDA has handed Gilead, one of the most profitable pharmaceutical corporations on earth, a long and entirely undeserved seven-year monopoly and with it, the ability to charge outrageous prices to consumers. Gilead has gamed the system by rushing through its “rare disease” orphan drug application while there are, for this brief moment, fewer than 200,000 COVID-19 U.S. cases. Its action is disingenuous and outrageous, and underscores the need for the federal government to step in.

Total Cost of Uninsured Woman's COVID-19 Treatment: $34,927.43

She was uninsured. It appears that she didn't even spend any time in an ICU, she received outpatient care in an emergency room. Wouldn't it be great if we had Medicare for All? Except there is one little problem, both candidates, Biden and Trump- unless Bernie pulls off a miracle would veto it. There is a really simple reason for that. WE SIGNED AWAY THE RIGHT TO REGULATE HEALTH INSURANCE MORE THAN 20 YEARS AGO in the GATS agreement, part of the WTO, but the country never got the memo!

ICU beds already near capacity with non-coronavirus patients at L.A. County hospitals

ICU beds at Los Angeles County hospitals are already at or near capacity, prompting worries of shortages ahead of expected coronavirus surge By MATT STILES, IRIS LEE MARCH 20, 20204:27 PM Intensive care beds at Los Angeles County’s emergency-room hospitals are already at or near capacity, even as those facilities have doubled the number available for COVID-19 patients in recent days, according to newly released data obtained by The Times. Fewer than 200 ICU beds were available Wednesday, with most ICU beds occupied by non-coronavirus patients, according to the data which covers the roughly 70 public and private hospitals in Los Angeles County that receive emergency patients. The figures, which haven’t been disclosed previously, offer the first real-time glimpse of capacity levels at hospitals from Long Beach to the Antelope Valley and raise fresh worries that the hospital system, which is already strained by shortages, could soon run short of beds. “I am very concerned. We have a limited number of ICU beds available in L.A. County,” said Supervisor Janice Hahn, who urged residents to heed social-distancing orders to reduce infection rates and strain on medical resources. “I would like to begin exploring every possible solution to increase the capacity of our hospital system, including building pop-up hospital sites.” The anticipated surge of coronavirus patients is setting off a scramble to increase capacity of all types of beds, some of which could be converted to ICU units, according to county health officials. To accomplish that, hospitals are halting elective services to open up more space, and are considering other plans to expand capacity, including converting existing space or erecting tents. That effort shows in the figures, with the number of beds overall nearly doubling in the last several days — from 624 on March 13 to 1,182 as of Wednesday. That change includes an increase of ICU beds, which have more equipment and a higher staff-to-patient ratio, from 85 to 191, according to the figures. Christina Ghaly, a physician who directs the county’s vast system of providers, clinics, and hospitals known as the Department of Health Services, said hospitals can add ICU beds by converting existing space. That entails equipping beds with special equipment and adding personnel and, in some cases, getting approval from state regulators. Rooms could also be opened in non-emergency room hospitals, which aren’t included in the current figures. “The hospitals across the entire county are working very hard to free up capacity, and also to create capacity,” said Ghaly. County officials stressed that the figures represent the current staffing needs by hospitals, which have a greater “surge” capacity as more patients get sick. She said they are also asking state officials to fast-track additional capacity. But despite the progress, as many as 90% percent of licensed ICU beds are already occupied with patients who have suffered other medical emergencies, such as heart attacks, car accidents and other cases, according Ghaly said.

We need to prevent the creation of a hospital to prison pipeline.

One of my anxieties about the capture of the US by corporations, is what seems to me to be a slow slide back into the worst aspects of the past. This is due to the global forces so afraid that the positive changes that happened in the last century would continue that neaar the end of the last century they set up a scheme to lock the entire planet into their bad movie, for good. they have literally been trying to take over the planet in order to reverse all that progress, and they have been succeeding. And we're letting them, largely because we dont know, which is a huge mistake. They are not normal people or normal politicians, they are compulsive liars.

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)

"Estimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: [82%–90%]) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging."

A Country in Denial, and not just about COVID-19

With our for-profit system being too expensive for the vast majority of Americans to afford without being bankrupted, due to very very high rates of uninsurance and underinsurance, a very great fear is that this COVID-19 epidemic will be the straw that breaks the camels back.

Indian Company Offers to Supply AIDS Drugs at Low Cost in Africa (New York Times, Feb. 7, 2001)

(This is the story depicted in the Fire in the Blood film) By Donald G. McNeil Jr. In a move that could force big drug multinationals to cut the prices of their AIDS drugs in poor countries, an Indian company offered today to supply triple-therapy drug ''cocktails'' for $350 a year per patient to a doctors' group working in Africa. The Indian company, Cipla Ltd. of Bombay, a major manufacturer of generic drugs, made the offer to Doctors Without Borders, which won the Nobel Peace Prize in 1999 for its work in war-torn and impoverished areas. In Africa the group sets up small pilot programs to develop models for broader approaches to combat AIDS, and would distribute the Cipla drugs free. As part of its program, Cipla would also sell the drugs to larger government programs for $600 a year per patient, about $400 below the price offered by the companies that hold the patents. ''This is the way to break the stranglehold of the multinationals,'' said Dr. Yusuf K. Hamied, chairman of Cipla, who will meet with the doctors' group on Feb. 15 to discuss strategy. For two years, Doctors Without Borders has led an aggressive campaign to force multinationals to cut prices on life-saving drugs for the world's poorest patients. Other parties in the campaign are the Philadelphia and Paris chapters of the AIDS Coalition to Unleash Power, and the Consumer Project on Technology, a Washington group started by Ralph Nader. The normal cost of the AIDS cocktail in the West is $10,000 to $15,000 a year. Last May five multinationals, backed by the World Health Organization and other United Nations agencies, offered to sell their components to poor nations at sharply reduced prices. But Cipla and other makers of generic drugs in Brazil, Thailand and other countries have not been part of the talks with W.H.O., a situation that Cipla hopes to change with its aggressive entry onto the scene. The country-by-country negotiations about how the multinationals distribute the drugs have gone slowly, and so far only Uganda, Senegal and Rwanda have agreements. The companies refuse to release figures, but the cost of a typical cocktail in Senegal is $1,000 a year, according to Doctors Without Borders. Dr. Bernard Pecoul, director of the Access to Essential Medicines project for Doctors Without Borders, said the Cipla offer, which he learned of only today, ''will let us start up our pilot projects on a larger scale.'' The doctors' group has 40 AIDS projects around the world, about half in Africa, where the infection rate reaches as high as 36 percent. Only five of these pilot programs are giving out antiretroviral cocktails. With the Cipla offer, or matching ones from other companies, up to 20 could be distributing the drugs by the end of year. Cipla is offering to sell the agency as many doses as it is wants at $350 a year. Dr. Hamied said that his company would lose money at that price, but that he would supply ''10,000 doses or 20,000 or 30,000, however many they want.'' The $600 price to governments is near Cipla's break-even point, he said, but costs could drop with greater production. If that happens, he would cut prices further. In India he sells the same cocktail for about $1,100 a year. But he denied that he was trying to grab market share in Africa. ''What do I want with market share?'' he asked. ''I don't have a monopoly, and the only way to make real money in drugs is with a monopoly. In this disaster, there is room for everybody.'' Wide distribution of the drugs in Africa is not without critics, given the attendant need for careful monitoring. Some experts argue that it would be better to spend the money on providing clean water, controlling malaria and increasing the use of condoms. But Doctors Without Borders says that the dangers and side effects of the drugs pale beside the immensity of the epidemic itself, and that Western testing standards are overcautious. The typical AIDS cocktail is a combination of any three of about nine protease inhibitors or reverse transcriptase inhibitors. The chemicals suppress the human immunodeficiency virus but, as with any chemical therapy, they are toxic and can damage the liver. In the West, doctors carefully monitor the levels of the drug in the blood, test for organ damage and check the levels of the virus in the bloodstream. If the virus mutates to resist the therapy, the combinations are changed. Careful monitoring may not be possible in many African settings. But with 25 million Africans infected with the AIDS virus, Doctors Without Borders and other agencies argue, imperfect treatment is better than none. Dr. Pecoul pointed out that large numbers of infected Africans live in urban areas where, ''with a quite simple clinic, you can deal with anti retrovirals.'' He is also ''not convinced'' that the batteries of tests routinely ordered for Western patients are really necessary. ''Some people suggest that H.I.V. testing and clinical followup can be enough,'' he added. The Cipla drug combination is two tablets of 40 milligrams of stavudine, two tablets of 150 milligrams of lamivudine and two tablets of 200 milligrams of nevirapine. In the United States and many other countries, the Bristol-Myers Squibb Company holds the patent on stavudine, also known as Zerit or d4T; Glaxo-Wellcome of Britain holds the patent on lamivudine, also known as Heptovir or 3TC, and Boerhinger Ingelheim G.m.b.H. of Germany holds the patent on nevirapine, or Viramune. Western drug companies have shown themselves determined to defend their patent rights to be sole distributors throughout the world, and Dr. John Wecker, head of Boerhinger Ingelheim's efforts to negotiate cheaper prices in Africa, said he did not yet know what his company would do if Cipla undercut its prices. ''We offer a standard quality from the original manufacturer and can meet any demand that exists out there that can be delivered with safe procedures,'' he said. He refused repeatedly to say at what price Boerhinger Ingelheim sells nevirapine to Senegal or Uganda, saying, ''Affordability is an issue, but not the major issue.'' Representatives from Glaxo-Wellcome and Bristol-Myers did not return phone calls, but the three companies can be expected to wage a hard fight against the distribution of generic versions of their drugs. Late last year, Glaxo-Wellcome threatened to sue Cipla when it tried to sell Duovir, its generic version of Glaxo's Combivir, a lamivudine/zidovudine combination, in Ghana. Cipla offered the drug for $1.74 a day; Glaxo had cut its price to $2, from $16. But even though the African regional patent authority said Glaxo's patents were not valid in Ghana, Cipla backed down and stopped selling Duovir. Asked what he would do if the three drug companies sued to stop him, Dr. Hamied said: ''We won't fight it. I don't look at it as a fight. There's room for everybody. This is a holocaust in Africa. It's like the earthquake in India right now -- everybody is helping out. I'm not looking to pick anybody's business; there's room for the multinationals at their price and room for us at our price, a partnership.''

The race to patent the SARS virus: the TRIPS agreement and access to essential medicines

by Matthew Rimmer. "[This article considers the race to sequence the Severe Acute Respiratory Syndrome virus (‘the SARS virus’) in light of the debate over patent law and access to essential medicines. Part II evaluates the claims of public research institutions in Canada, the United States, and Hong Kong, and commercial companies, to patent rights in respect of the SARS virus. It highlights the dilemma of ‘defensive patenting’ — the tension between securing private patent rights and facilitating public disclosure of information and research. Part III considers the race to patent the SARS virus in light of wider policy debates over gene patents. It examines the application of such patent criteria as novelty, inventive step, utility, and secret use. It contends that there is a need to reform the patent system to accommodate the global nature of scientific inquiry, the unique nature of genetics, and the pace of technological change. Part IV examines the role played by the World Trade Organization and the World Health Organization in dealing with patent law and access to essential medicines. The article contends that there is a need to ensure that the patent system is sufficiently flexible and adaptable to accommodate international research efforts on infectious diseases.]"

The Hidden Holocaust -

25 years ago a scheme, to make drugs much more expensive, came into force - along with the WTO. with the creation of the WTO -and tellingly, this was also in the middle of an epidemic, like today.

Coronavirus: ‘We must choose who to treat,’ says Italian doctor

In Italian doctor in Lombardy, a region of Italy that has been quarantined due to the new coronavirus (Covid-19) outbreak, has stated that doctors have to choose who to treat “according to age and state of health, as in war situations.” “To say that you do not die from the coronavirus is a lie that fills me with bitterness,” said Dr. Christian Salaroli, an anaesthetist, in an interview with the Italian daily Il Corriere della Sera on Monday. Salaroli said that the emergency is so big in Italy that he and his colleagues must now select the patients who will or will not be able to access mechanical resuscitation (by intubation) from among the most seriously ill. Patients with viral pneumonia, and are in acute respiratory failure, are first placed on non-invasive ventilation (NIV), using an oxygen mask. “It’s a first step, but after a few days, we have to choose. Since there is, unfortunately, a disproportion between hospital resources, resuscitation beds and critically ill patients, not everyone can be intubated,” Salaroli said. “We decide based on age and state of health,” he added. “If a person between 80 and 95 years old has severe respiratory failure, it’s likely we will not go ahead. If they have multi-organ failure, with more than two or three vital organs, it means that their mortality rate is 100%,” he added. Asked about the Italian government’s decision to quarantine more than 15 million people in northern Italy in an attempt to contain the epidemic, Salaroli said it was “fair but a week late.”

Market Spiral Pricing of Cancer Drugs

By Donald W. Light. "Companies are spiraling up high prices, not because of costs or better value, but because they can get away with it, in - only the USA. Senior oncologist, Hagop Kantarjian, and I show that very high prices for cancer & specialty drugs are not due to high costs of research, nor to added clinical value. Companies are simply spiraling up prices already 2-3 times greater than other capitalist countries allow, because we allow them to. High co-pays hurt patients and impede good clinical care. This exploitation of serious ill patients and taxpayers is ethically troubling and must stop."

Inside America's woefully ill-prepared health system

"by Jacob Greber: The US healthcare system, so expensive that people actively avoid hospitals, could become the defining political issue of a presidential election year." "One American every 30 seconds is bankrupted by medical bills."

Coronavirus Time Bomb: America's Uninsured and Brutal Work Culture

As the virus began spreading in the west of the country, where the nation's first death was reported on February 29, public health experts warned the US has several characteristics unique among wealthy nations that make it vulnerable. These include a large and growing population without medical insurance, the 11 million or so undocumented migrants afraid to come into contact with authorities, and a culture of "powering through" when sick for fear of losing one's job. "These are all things that can perpetuate the spread of a virus," said Brandon Brown, an epidemiologist at UC Riverside. The number of Americans without health insurance began falling from a high of 46.7 million in 2010 following the passage of Obamacare (the Affordable Care Act), but has risen again over the past two years.

Coronavirus outbreak worries hourly workers without paid sick time

In addition to missed business opportunities, those who are self-employed or hourly workers, like Placido Borrequero, a Pilsen father of three, who is worried about how he will continue to put food on the table if the virus spreads to him. Borreguero works in landscaping and lawn care. "I don't have any sick days. If I am sick I don't work that day, I don't get paid that day. That's why I am really worried," he said. Leone Bicchieri is the executive director of Working Family Solidarity, located in the Pilsen neighborhood. He says he has been hearing from people on the south and west sides who are already struggling to make ends meet, concerned about access to healthcare and supporting their families. "If they miss one or two days work and they are already behind a month or two in the bills, they are going to be evicted and now they're going to be homeless," Bicchieri said. He wants to know what the plan is to help these workers if the virus continues to spread. "The government really need to get behind this, needs to tell businesses and companies. Please do not fire or discipline low wage workers who have to stay home," Bicchieri said. "I have a wife and three children. What's going to happen to them. I am the main bread winner," Borreguero said.