Is Thailand's hepatitis C treatment program at risk from its plans to
join an Asia-Pacific trade pact?
Abstract
Thailand has expressed interest in joining the Comprehensive and
Progressive Agreement for Trans-Pacific Partnership (CPTPP), an
11-country plurilateral trade agreement whose original incarnation
included the United States of America (USA). When the USA withdrew from
this agreement, key intellectual property clauses relevant to
pharmaceuticals were suspended. These could be reinstated should the USA
decide to re-join. This study aimed to measure the impact of these
suspended clauses by costing Thailand’s 2020 hepatitis C treatment
program under four scenarios: 1) existing treatment regime, which does
not use the currently recommended treatment regime and does not source
the lowest price medicines, 2) treatment regime if Thailand joined the
CPTPP and suspended clauses were reinstated, 3) treatment regime if
Thailand utilised flexibilities in international law enabling access to
the cheapest direct acting antivirals on the global market and 4)
lowest-cost generic pan-genotypic regime on the global market. Joining
the CPTPP would increase the cost of Thailand’s hepatitis C treatment
program more than tenfold if suspended CPTPP clauses were reinstated and
TRIPS flexibilities not fully utilised. Within the existing budget, the
price and regime for scenario 4 would enable an additional 7,571 people
to access hepatitis C treatment and avoid the need for genotype testing.
Signing trade agreements such as the CPTPP that require stronger
intellectual property protections could compromise Thailand’s hepatitis
C program and other national treatment programs reliant on affordable
generic medicines and prevent it from relying on its own pharmaceutical
capabilities to manufacture medicines needed to sustain its treatment
programs.