Tuesday, March 03, 2015

Trans Pacific Partnership a threat to health, says assessment

A comprehensive review of the proposed Trans Pacific Partnership between Australia and 11 other nations including the United States and Japan has found it is likely to push up the price of medicines, stop some Australians from taking their medicines and make it harder to restrict the sale of tobacco and alcohol.

The so-called health impact statement, compiled by the Centre for Health Equity Training Research and Evaluation at the University of NSW relies on leaked texts of draft chapters of the agreement Australia is preparing to seal within weeks.

More than 20 chapters long, the text won’t be made public until after the the trade ministers shake hands at a meeting in Hawaii set down for next month.

The Trans Pacific Partnership encompasses almost 40 per cent of the world’s economy: the industrialised nations of Australia, Canada, Singapore, Brunei, New Zealand, Chile, Mexico, the United States and Japan alongside the less developed nations of Malaysia, Peru, and Vietnam.

Although its stated aim is to bring down trade barriers and allow mutual recognition of standards, many of its provisions deal with medicines and make it difficult for member countries to move against foreign owned corporations.

The health impact statement follows Commonwealth guidelines for such statement in place for more than a decade. Although such statements are not required for new projects in the same way as are environmental impact statements they are an accepted procedure for establishing the impact of new proposals on health.

Prepared by five health specialists from the universities of Sydney and NSW and La Trobe University the assessment took 15 months, beginning in late 2013 after some drafts texts of were published by Wikileaks...

The report says the US is seeking to prevent signatories from refusing to grant patents for minor variations to existing drugs even when there is no evidence of additional benefit. It says the provision would encourage “evergreening” where manufacturers gain extra patents to extend their monopolies in order to ward off competition from generics.

The US is also seeking to lengthen the period during which generic manufacturers cannot use clinical trial data produced by a manufacturer to obtain marketing approval. Under the Australia-U.S. Free Trade Agreement, Australia already provides at least 5 years of protection. The US is seeking at least 3 additional years of protection for new uses of existing drugs and 12 years for so called biologic drugs and vaccines.

The provisions in the draft healthcare transparency annex of the agreement would outlaw therapeutic reference pricing, a mechanism for ensuring that the prices paid for medicines reflects their clinical benefit and require more consultation with drug manufacturers about listing and pricing decisions.

“In the past, the Pharmaceutical Benefits Scheme has increased patient co-payments in order to accommodate rising costs,” the report says.

“A systematic review of evidence from 1990 to 2011 found that co-payments decrease prescription use, can impact patient medicine use compliance, and can adversely impact disadvantaged populations.”

The report finds that proposed investor-state dispute settlement procedures would make it difficult for governments to legislate in ways that harmed tobacco, alcohol or food manufacturers.

Trade minister Andrew Robb told Fairfax Media last month that many of the critics had only seen proposals, not what would be in the final agreement.

“I am not going to do something that I think is not in the public interest,” he said.

In The Age and Sydney Morning Herald

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