The Trans-Pacific Partnership will increase healthcare costs by pressuring countries to grant monopolies to drug companies if existing drugs are found to be effective against other diseases.

The near-finalized version of the TPP Chapter on Intellectual Property Rights gives signatory countries the ability to grant pharmaceuticals three years of “market exclusivity” for new forms and uses of old medicines, preventing cheaper, genetic drugs from competing.

For example, the drug Zidovudine was first discovered as an effective cancer treatment in 1964 and years later, in 1987, it was also found to be effective against HIV, and under the TPP it would be illegal for generic drug makers to compete with the decades-old Zidovudine in the HIV market for at least three years.

“Zidovudine cost about $7,000 per person per year at the monopoly price (new HIV indication) when it was introduced while the price of the generic version (cancer indication) had fallen to $70 per person per year by June 2013,” government watchdog group Public Citizen reported. “This is an example of the kind of price differences which could occur in TPP countries if they choose this implementation option of providing three-year monopolies for new indications.”

And this will lead to the deaths of thousands of patients who can’t afford the monopoly price.

Currently the United States offers seven-year market exclusivity for repurposed drugs, but only if the drug treats a “rare disease” affecting less than 200,000 people, as defined by the Orphan Drug Act of 1983.

Public Citizen also pointed out the TPP may also grant “market exclusivity” if a decades-old drug used for adults is also found to be effective with children years after its introduction.

“The new monopoly rights for big pharmaceutical firms would compromise access to medicines in TPP countries,” Peter Maybarduk, Public Citizen’s Global Access to Medicines Program Director. “The TPP would cost lives.”

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