E-drug: Re: US compusory licensing proposal for medicines (cont)
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John Urquhart makes the case against compulsory licensing but some of
what he says does not fit the reality. Canada had compulsory licensing
to import medications between 1969-1991. In the early 1980s there was a
government commission of inquiry that looked into the effects of
compulsory licensing. One of the things that the commission found was
that since the introduction of compulsory licensing, although profit
levels in Canada were lower than in the United States they were
generally higher than in most other well-developed countries in the
world. Furthermore, in 1983 the sale of compulsory licensed drugs by
generic firms amounted to 3 percent of the sale of all pharmaceutical
products in Canada. Another of the conclusions of this inquiry was "that
growth has been more buoyant [in the pharmaceutical industry] in Canada
than it has been in the United States since 1967." It is clear that if
there was any negative economic impact from compulsory licensing it was
minimal. Would things have been different in the United States? Despite
their similarities the United States does have a different
pharmaceutical market than Canada and it is possible that there might
have been some negative impact, but it is hard to imagine that it would
have been that great.
Finally, just a comment about how useful new pharmaceutical products
are. Here are the statistics that Prescrire International presented in a
recent issue, covering the period 1981-2000:
Category
Number Percent
Major therapeutic innovation
7 0.31
in an area where previously
no treatment was available
Product is an important therapeutic
67 2.96
innovation but has certain limitations
Product has some value but does not
192 8.51
fundamentally change the present
therapeutic practice
Product has minimal additional value,
397 17.59
and should not change prescribing habits
except in rare circumstances
Product may be a new molecule but is
1427 63.23
superfluous because it does not add
to the clinical possibilities offered by
previous products available. In most
cases it concerns a me-too product
Product without evident benefit but with
58 2.57
potential or real disadvantages
Editors postpone their judgements until
109 4.83
better data and a more thorough
evaluation of the drug is available
Total
2257 100
--
Joel Lexchin MD
121 Walmer Rd.
Toronto, Ontario
Canada M5R 2X8
T: +416-964-7186
F: +416-923-9515
e mail: joel.lexchin@utoronto.ca
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