BANGKOK, March 18, 2007 (AFP) - Thailand's health minister has threatened to expand the country's generic drug programme to include cancer and more AIDS medications, unless pharmaceutical companies sharply cut their prices.
In an interview with AFP, Health Minister Mongkol Na Songkhla said he was undeterred by the fierce resistance from drugmakers to his trailblazing drive to issue so-called "compulsory licences" for high-priced medications.
"I will continue to negotiate with drug companies" to reduce prices of AIDS, cancer and heart disease medications, Mongkol told AFP.
"But if negotiations fail, we are ready to act," the 65-year-old general practitioner said.
Under the rules of the World Trade Organisation, countries are allowed to order compulsory licenses that temporarily suspend patents and clear the way for generic drugs to protect public health in an emergency.
Few countries have actually used this provision.
But since Mongkol was appointed as health minister by the military after a September coup, he has jolted the powerful pharmaceutical industry by allowing generic versions of two anti-AIDS drugs -- Efavirenz and Kaletra -- and popular heart disease medicine Plavix.
The decision drew outrage from the industry with Thailand's top pharmaceutical group calling it "a stunning blow" to foreign investment already hit by political uncertainty since the coup.
"This is unprecedented in Thailand. If the government decides to allow more generic drugs, it will further damage the image of Thailand among international investors," said Teera Chakajnardom, president of Pharmaceutical Research and Manufacturer's Association of Thailand.
Angered by Mongkol's decision, US drug giant Abbott Laboratories, the maker of AIDS drug Kaletra, said this week it would stop selling new drugs to Thailand -- including an improved version of Kaletra.
But Mongkol was unfazed by critics and corporate retaliations, saying that after years as a ministry bureaucrat involved in price negotiations with European and US drug giants, he was well aware of his opponents.
"Our ministry has been negotiating with drug companies over the past two years" to cut drug prices, he said. "But they did not cooperate with the ministry. Never. They were never interested in negotiations.
"We've come to the point that we have to do something about it. We cannot wait and talk to them without any achievement."
Drugmakers say they have to charge high prices for new medicines to recover the enormous cost of research needed to bring new medications to market.
The minister said HIV/AIDS is Thailand's top cause of death, followed by heart disease.
Some 500,000 Thais are infected with HIV, but fewer than 10 percent of them can afford to buy Kaletra, he said.
Under the generic programme, treatment with Kaletra is expected to drop from 11,580 baht (330 dollars) per month to 4,000 baht per month, according to charity Doctors Without Borders (MSF).
Similarly, fewer than 10 percent of some 300,000 heart disease patients in Thailand can buy Plavix, a blood-thinning treatment to prevent heart attacks, according to the ministry.
The cost of Plavix, the world's second top-selling medicine, is expected to drop from 73 baht (two dollars) per day to fewer than seven baht under the generic program, the ministry said.
Paul Cawthorne, head of the MSF mission in Thailand, hailed Thailand's move and said Mongkol had complied with WTO rules.
"What the government has done so far is perfectly legal within Thai law and is also legal within the guidelines of the World Trade Organisation," said Cawthorne.
Mongkol said the government had to resort to the generic program in the face of a ballooning health care budget now at more than 250 billion baht (seven billion dollars) and projected to rise 10 percent every year.
"We want to help the poor. We have to use the compulsory licence for the poor people," he said, adding the government would import generic forms of the AIDS and heart drugs from India, a major source of copycat medications.
Former premier Thaksin Shinawatra, ousted by the military in the September putsch, set up an enormously popular health scheme allowing Thais to pay only 30 baht (about 80 US cents) for each visit to the doctor.
After the coup, the army-backed government went further by scrapping the 30-baht payment, creating a free-for-everyone health care system.
All of Thailand's 65 million people are eligible for the universal health plan unless they have coverage from their employer or qualify for other government insurance schemes.
The universal health scheme covers some 48.5 million, or 75 percent of the population, the ministry said.
Mongkol said drug giants should do more to cut prices of essential medicines to treat AIDS, cancer and heart diseases.
"If they voluntarily reduce prices to let the poor people access to essential drugs, there is no need to do compulsory licensing," he said. "We are doing everything to help the poor people."
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