我國經濟要和國際接軌似乎必須考慮加入美國主導的TPP,
但TPP的智財至上條款恐怕會對健保藥價構成強烈威脅,
然後總額有限的情況下,矛頭可能又轉向弱勢醫療勞動業...
下面來看看近期NEJM對TPP的觀點
The Trans-Pacific Partnership — Is It Bad for Your Health?
http://www.nejm.org/doi/full/10.1056/NEJMp1506158?query=TOC
The full health implications of the TPP are hard to judge, not only
because its provisions are complex but also because the draft text
is a closely held secret. Even members of the U.S. Congress can see
it only if they agree not to talk publicly about it and if they leave
their pens and phones (and, until recently, their expert staffers) at
the door. But several key chapters have recently been leaked and reveal
that the TPP could have a substantial impact on health.
(本段說明TPP草案仍是黑箱狀態,連美國國會議員都必須承諾不公開討論才能看)
Groups including Medecins sans Frontieres and Oxfam warn, for example,
that the agreement could threaten the lives of millions of people in
developing countries. Their concerns stem primarily from the leaked IP
chapter and the effect that patents have on the prices of medicines.
In the context of human immunodeficiency virus, for example, patents
increase the annual cost of antiretroviral therapy from around $100 per
person to $10,000 per person.
(HIV每人ART藥價翻100倍)
For example, India allows patents on new drugs but not on new uses of old
drugs or new forms of known drugs that do not increase therapeutic efficacy.
These provisions have paved the way for generic versions of lifesaving drugs
such as the cancer treatment imatinib mesylate (Gleevec) in that country.1
But such limits on patent eligibility could be outlawed by the TPP. Reports
suggest that there may be some kind of phase-in period for developing-country
members, but only for some parts of the agreement.
(印度只承認新藥專利,不接受舊藥新用或者沒增加療效的舊藥新劑型,但這違反TPP)
Though it is less widely recognized, the TPP could also have a direct effect
on health in developed countries. For example, the leaked IP chapter
contemplates major extensions of “data exclusivity” provisions. These laws
prevent drug regulatory agencies like the Food and Drug Administration from
registering a generic version of a drug for a certain number of years — and
as a result can substantially affect the prices of medicines.
(藥品資料專屬權讓專利期過後還得過一定年限學名藥才能申請藥證)
評: 這根本是變相延長專利壟斷期...
因為學名藥廠必須要重新跑一遍藥品開發過程非常花錢的phase 1-4的trial,
但花大筆錢跑完後卻沒有原廠當初跑完可以得到的專利權,可能血本無歸,
多數藥廠應該會直接放棄進入市場,原廠將可以繼續保有市場壟斷地位...
總結來說,
自由主義的美國卻總是動用政府間契約威權強制來保障少數大藥廠的壟斷利益...