Assessing the impact of alternative patent systems on the cost of health care: the TPPA and HIV treatment in Vietnam

Abstract

In the Trans Pacific partnership Agreement (TPPA) negotiations, the United States has proposed expanded patent protections that will likely impact the affordability of medicines in TPPA partners. This includes antiretroviral (ARV) medicines used in the treatment of HIV/AIDS. Vietnam has the lowest GDP per capita (US$1,911 in 2013) of the 12 countries participating in the TPPA negotiations. By the end of 2013 antiretroviral (ARV) therapy was provided to 68% of those meeting the clinical criteria for such medicines. Using the current Vietnamese patent regime as our base case, we analyse the potential impact of alternative patent regimes on access to ARVs in Vietnam. The two other scenarios investigated are a patent regime making full use of TRIPS flexibilities, and a regime based on the US proposals in the 2014 leaked draft of the TPPA intellectual property chapter. We identified the most commonly used ARV medicines and examined patent data sets to discover patents that had been registered for these. We then used information from these patents to identify which might be granted under alternative patent regimes. We then estimated prices under the three patent scenarios. The current ARV budget was used as a constraint. Our results indicate 82% of the HIV population eligible for treatment would receive ARVs under a full TRIPS flexibility scenario, while only 30% of Vietnam's eligible HIV patients would have access to ARVs under the US 2014 TPPA proposals - more than halving the proportion treated compared to the current 68%. Show more