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Cost-Containment Mechanisms for Essential Medicines, Including Antiretrovirals, in China - Health Economics and Drugs Series No. 013
(2003; 30 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentAcknowledgements
View the documentTerms of reference
Open this folder and view contentsIntroduction
View the documentBackground and experiences with voluntary agreements
View the documentCountry rights to be protected in voluntary agreements for reduction of prices of medicines
Open this folder and view contentsCompulsory licensing - practical aspects and procedures
View the documentConcluding comments
View the documentList of persons contacted
View the documentFurther reading

Concluding comments

1. In seeking to contain costs for ARVs and other essential medicines, China should consider the full panopoly of available policy tools, and examine closely how the various tools may complement one another.

2. In making policy choices related to cost-containment, including use of TRIPS flexibilities and safeguards, China should prioritize public health considerations. Affordability of essential medicines is a public health priority.

3. Voluntary negotiations can lead to substantial price reductions for on-patent medicines in developing countries. China will be strongest in negotiating for voluntary discounts if it has reviewed its options for compulsory licensing and domestic production, and can credibly present these approaches as an alternative to deep discounts.

4. Voluntarily offered price reductions may be accompanied by limiting conditions. These may limit the number or type of beneficiaries of the price reduction, impose significant burdens on the government, or limit the government's ability to deploy varying policy tools. The government may or may not decide that these limitations are an acceptable trade-off for the benefits of price discounts; but it should be aware both of the costs, and its options.

5. WHO supports measures which improve access to essential medicines, including application of TRIPS safeguards.

6. By introducing competition, compulsory licensing may significantly reduce the price of ARVs and other essential medicines.

7. Compulsory licensing is widely used in some industrialized countries, and is an integral part of the intellectual property system. If China chooses to proceed with the issuance of compulsory licences for some essential medicines, it will be showing its commitment to the patent system. That is, rather than ignoring patents or engaging in underground counterfeiting, the government would be addressing access concerns from within the patent system. The government would be indicating its respect for the patent system, even where crucial public health matters are at stake.


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