Patent pool touted to benefit poor countries, seen ‘breaking the back’ of pandemic

Highlights
Low-cost versions of new COVID pills could soon be available to billions of people, especially in low-income countries, advocates of "patent pooling” said.
Two deals that enable the legal manufacturing of generic versions of new oral antivirals will also make “drug patent wars” unlikely, thanks to a voluntary licensing agreement signed by Medicines Patent Pool (MPP) with Pfizer and Merck. Advocates see this development as potentially “breaking the back” of SARS-CoV-2 once and for all.
Here's what we know so far:
It is a UN-backed public health organisation working to boost access to and facilitate the development of life-saving medicines for low- and middle-income countries.
“Pooling” of drug patents paves the way for high-quality copies of the branded versions of new drugs — almost immediately after they are licensed — and without breaking the bank of poor nations. This process — the move from branded drugs to generics — used to take an average of 8 years. Now, it can be shortened to as quick as two months.
The business model is voluntary. A “master” license is granted by a drugmaker to MPP, which in turn can grant “sub-licenses” to other manufacturers to produce generic versions of the pill.
MPP, based in Geneva, partners with civil society, governments, international organisations, industry, patient groups, and other stakeholders, to prioritise — and license — needed medicines and pool intellectual property to encourage generic manufacture and the development of new formulations. It talks to pharmaceutical companies to strike a patent pool deal as a negotiating bloc.
To date, MPP has signed agreements with 11 patent holders for the following:
There are two so far: one each with Merck and Pfizer. In October, Merck announced that it had agreed to share the license for molnupiravir, which fights the coronavirus by inhibiting its viral RNA replication. Clinical trials show it cuts the rates of hospitalisation and death of high-risk adults by 50%.
On Tuesday (November 15), Pfizer announced it will “sub-licence” the production of paxlovid, its candidate pill against COVID-19 to generic drug manufacturers. Trial results show the pill [trial codename: PF-07321332], cuts the risk of hospitalisation and death from COVID-19 by 89%.
For Merck, it will create broad access to molnupiravir in 105 low- and middle-income countries. The Pfizer-MPP deal aims to make paxlovid available in 95 low- and middle-income nations, which account for around 53% of the world’s population.
No specific value was mentioned. Pfizer and MPP announced that, if approved, the pill would be offered on a “tiered pricing”, based on a country’s ability to pay. Lower-income countries would pay a not-for-profit price. Business Insider, reported that while some countries will be paying $12 per patient, the US government has already ordered 1.7 million treatment courses, at about $712/patient.
The pill could be on the market in “a matter of months” if approved, MPP policy chief Esteban Burrone told AFP.
Doctors Without Borders (MSF), suggested paxlovid might cost around $712 per Pfizer treatment course, in line with molnupiravir. MSF said that though the MPP deal was voluntary, it remains “restrictive” — and that it’s no substitute for guaranteed global access to COVID tools to bring the pandemic under control.
Market forces
Merck has reportedly signed deals with eight generic drugmakers, allowing each of them to sell molnupiravir in more than 100 low- and middle-income countries. The generic drugmakers will compete on price: one report claims the generics makers will charge about $12 to $15 per course.
Both Merck and Pfizer said they they will not receive royalties from the generic manufacturers, thus potentially making the treatment cheaper. The deals are contingent on the pill getting regulatory approvals.
PATENTS FOR DRUGS:
Medicines, as well as the processes required to produce them, are patentable under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organisation. The TRIPS Agreement came into force as part of the WTO Agreement on January 1, 1995.
Merck said it plans to double its own production of molnupiravir from 10 million treatment courses in 2021 to at least 20 million in 2022 to meet demand. The UK, which approved it on November 4, 2021, will start to roll out molnupiravir COVID-19 antiviral pill through a drug trial later this November.
Paxlovid pill is not yet available to the public. On Tuesday (November 16), Pfizer said it was seeking US regulatory approval for emergency use of the pill. Though initial supplies would be limited, production will be ramped up once it is approved in various jurisdictions and generics manufacturers are granted sub-licenses.
In general, pills are easier to make than vaccines. Other benefits include:
If authorised or approved, the oral drug will be "well-suited for low- and middle-income countries and could play a critical role in saving lives” and quelling the pandemic, Charles Gore, executive director of the UN-backed Medicines Patent Pool (MPP), said in a statement.
Experience shows that competition from manufacturers of generic drugs, the prices of antiretroviral (ARV) medicines have dramatically dropped.
For example, in the year 2000, the cost for first-line ARV treatment was over $10,000 per patient per year; in 2018, the cost has decreased to as low as $60-$80 per patient per year. In India, antiretroviral (ARV) therapy drugs are given free to people living with HIV/ Aids.
Generic medicine vs patent medicine:
A branded drug (or "patent medicine”) is a drug protected by patent; while drug which is a copy of branded drug and is equivalent in terms of safety, efficacy, dosage and use is called a generic drug. Generic drugs generally cost less.
Currently, the term of a new patent is 20 years from the date on which the application for the patent was filed in the US. However, many other factors can affect the duration of a patent.
It was in 2002, during a meeting of treatment activists, when AIDS had become a chronic disease and expensive medication was only available in rich countries. In 2010, after 8 years, the MP) was founded with support from Unitaid, which continues to be its main funder. The pool’s work on access to essential medicines is also funded by the Swiss Agency for Development and Cooperation (SDC).
It is not immediately clear when US regulators will rule on Pfizer’s application. Merck’s molnupiravir completed their EUA submission on Oct. 11. FDA advisers will meet on November 30 to consider the application.
Pfizer said it has also begun the process of seeking authorisation in several countries:
WRIGHT BROTHERS' ‘PATENT WAR’
In 1906, the Wrights received a patent for their method of flight control. Their company, Wright Brothers Co., engaged in Patent Wars, to secure a monopoly on US aircraft manufacturing. Of the nine suits brought by them and three against them, the Wright brothers eventually won every case in US courts. The patent war created a crisis in the US aviation industry. In 1917, the two major patent holders, the Wright Co. and the Curtiss Co., had effectively blocked the building of new airplanes. As a consequence, the aviation industry development in the US fell so far behind Europe that, in World War I, American pilots were forced to fly European combat aircraft instead. In the midst of the war, the US government decided to take action and forced the aviation industry to form an organisation to share patents. It was the first known US patent pool. All aircraft manufacturers were mandated to join the Manufacturer’s Aircraft Association, with each member required to pay a small “blanket fee” (for the use of aviation patents) for each airplane manufactured; of that, the major part would go to the Wright-Martin and Curtiss companies, until their respective patents expired. The arrangement was designed to last only for the duration of the war. In 1918, the litigation was never renewed. Wilbur had died in 1912 and Orville had sold his interest to a group of New York financiers in 1915 and retired from the business. The “patent war” had come to an end.